In the hysterical form we see rather a rare variety of convergent
squint, which is conditional on contraction of the interni through
restriction of movement of the externi. Hysterical symptoms may at the
same time appear in the eyes or elsewhere, still this does not always
happen. As these cases are rare I will relate a few of those I have
observed. (These cases are not included in the above statistics.)
CASE 10. Anna R--, æt. 20, came under treatment in February, 1878,
stating that on the previous day she perceived blindness of the right
eye on waking; in the afternoon she felt particularly weary, and after
she had slept about an hour woke with blindness in both eyes. No
perception of light, good pupillary reaction, ophthalmoscopic report
normal. Patient was treated with copious enemata and dismissed on the
fifth day cured.
In February, 1880, she again came under treatment with blindness of both
eyes, also perceived the previous day on waking. Convergent strabismus
was present at the same time, of such a degree that the eyes converged
to a point 10 to 20 cm. distant. The outward movement was suspended in
both eyes. The attempt to turn the eye outwards is accompanied by short
convulsive movements, and followed by an immediate rebound to the
convergent position. She asserts her inability to see the movements of a
hand before her eyes, is able, however, to move about in a strange room,
unsteadily certainly, but with avoidance of obstacles; she sits down on
a chair indicated to her, &c. The position of the eyes proves that there
was no simulation in all this; it would be impossible for any person to
simulate a strong convergent squint continuously for four to five days.
Eight days after her admission the patient was dismissed with normal
movement of the eyes and good vision.
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