CASE 20.--Margarethe T--, æt. 16, has hypermetropia 2 D. in the right
eye, V. 5/6, in the left the ophthalmoscope shows with an otherwise
normal condition a higher degree of hypermetropia, with + 6·5 D., V.
1/18, with + 10 D. No. 3·0 is read. No spectacles have been used until
now; for the past few years school tasks have been performed with a
certain effort, only during the last year the asthenopia has increased.
Squint is not present, and with prisms as well as with the stereoscope
(by the use of objects, whose size corresponds to the defective sight on
the left side) binocular fusion can be proved.
The case is the same as regards divergent strabismus.
CASE 21.--Mr. H--, æt. 28, has myopia 6 D., V. 6/9 in the right eye; the
left eye has always been weak sighted, emmetropia is detected with the
ophthalmoscope, with normal fundus, V. 1/18. No squint, binocular fusion
can be proved with prisms.
CASE 22.--Mr. B--, æt. 47, has hypermetropia 5 D., V. 5/9 in the right
eye. Left eye with + 5 D., V. 1/18 (a few letters of 12 also were
recognised at 1 m.). It seems, however, that the patient is not able
exactly to indicate the position of the retinal images of his left eye,
he does not know, as he expresses himself, "whether the letters stand
here or there." Patient observed the defective sight long ago; the
ophthalmoscopic condition is normal. Patient really comes on account of
his son, aged 7-1/2, in whom hypermetropia of 3·5 dioptres is detected
with the ophthalmoscope, right eye with + 3·5 V. 5/9. Left eye has
convergent squint, V. 1/36, No. 3·0 is read with + 6·5 D.
The hereditary tendency is seen also in the following case:
CASE 23.--Mrs. S--, æt. about 46, on the left H. 4 D., V. 5/18 to 5/12,
has used no spectacles until now, and reads No. 0·75 without glasses at
about 15 cm. R. with + 4 D., V. 1/18, with + 6·5 D. large letters of No.
5·0 are recognised.
Two sons, present at the same time, are hypermetropic. One has in either
eye V. 1/4, the other a slighter degree of congenital amblyopia.
CASE 24.--Johanna L--, æt. 4, came under treatment for a congenital
fibroma covered with hair, about the size of a cherry-stone, situated on
the outer corneal margin of the left eye, which was removed. Three years
later, when the child had learnt to read, emmetropia and full visual
acuteness was observed in the right eye, with the left No. 4·0 only is
read with difficulty. The ophthalmoscope shows a slight degree of
irregular astigmatism of the cornea, which in no way explains the
defective vision; the image of the fundus is perfectly clear and quite
normal.
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