The attempt has really been made to attribute the commencement of convergent strabismus to the accommodation even in emmetropia, and offers fresh proof how easily facts are overwhelmed by theories. Donders originally gave it as his opinion, that loss of power or paresis of the accommodation produces strabismus just as little as the decrease in the amount of accommodation which comes with increase of years; a year later, because he could not agree with Donders' theory, Javal declared the principal cause to be due to weakening of the accommodation and not the refraction, but without producing any other ground for the assertion than that of his own good pleasure. Afterwards, Donders sought to explain the occurrence of convergent strabismus in emmetropia by paresis of accommodation, which must indeed, according to his theory, produce the same result as hypermetropia. I content myself by reminding my readers, that at the age when convergent strabismus usually arises, between the second and third year of life, a determination of the near point is utterly impossible; a foundation in fact is therefore wanting to the theory. But, further, if paresis of accommodation really had the significance assigned to it, atropine, which is so frequently used in the ophthalmic treatment of children, would be followed by convergent strabismus. This is still more the case with diphtheritic paralysis of accommodation, which is present more frequently than we are aware of, for it is only a trouble to children in the schoolroom, in younger children it passes through its natural uninterrupted course of recovery unobserved, in hypermetropia as well as in emmetropia. If the accommodation were really of great importance in the occurrence of squint, convergent strabismus would frequently be an after symptom of diphtheria, which, as is known, is not the case. The few cases of squint which I have seen after diphtheria, had their origin in paresis of the external rectus, which was proved by the objective defect in movement, as well as by the disappearance of the squint, with the recovery of the paralysis of the abducens. That the accommodation can play a part, is shown by the rarity of periodic accommodative squint, but for the great majority we must seek the chief cause of squint in emmetropia and myopia, in elastic preponderance of the internal recti and insufficiency of the externi, and it is apparent that the same causes will also be influential in hypermetropia.