It happens especially in myopia that prisms of considerably more than 6°
to 8° are overcome by divergence, and certainly without causing any
inconvenience. Among the cases presented for examination, those, of
course, are most numerous where the patients have some complaint to
make, even if this have quite a different cause. In any case a divergent
position of the axes of vision corresponds to the balance of the
muscles, and this does not generally occur, for this reason, because
retaining binocular single vision necessitates a parallel or convergent
position of the eyes. Frequently, however, even a slight impediment to
binocular fusion, such as the application of a red glass to one eye,
suffices to procure preponderance in the elastic tensions of the
muscles, and to cause the fixed point to appear double. We can put a
stop to binocular single vision still more surely by applying to one eye
a prism with the base upwards or downwards. If the double images of a
point 4 to 5 meters distant show a crossed lateral position besides the
difference in height caused by the prism, we may assume that an
absolute divergent position of the eyes corresponds to the elastic
tension of the muscles; and the measure of the deviation will be given
by those prisms which, placed with the bases inwards before one or both
eyes, bring the double images perpendicularly over one another. As a
rule, in these cases the degree of divergence which occurs on cessation
of binocular single vision, is almost as great as the facultative
divergence, which may be reached in the interest of binocular single
vision.
V. Graefe designates as "dynamic squint" that condition in which the
position of divergence corresponding to the state of tension of the
muscles does not occur because binocular vision is retained. Without
clearly defined limits these conditions pass on into periodic squint,
when either diplopia occurs together with the divergence, or the habit
of binocular fusion becomes less frequent or is quite forgotten, while,
however, according to the varying state of the muscles sometimes normal
position, sometimes divergence, is present. A correct position of the
eyes is quite possible even without binocular fusion, then only the
regulator is wanting, which, in the varying play of the muscular forces,
ensures the balance of position and movement.
The older ophthalmologists had a parallel strabismus and probably
understood by that, what we now designate as relative divergence. The
connection between relative divergence and myopia, pointed out by
Donders, is universally admitted; on the other hand, in more modern
literature we scarcely find any intimation of the fact that a parallel
squint occurs, which is quite independent of myopia, and rests solely on
the fact that the impulse of innervation for convergence is lost. A few
examples may explain this condition.
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