Von Graefe, who first considered this defective sight to be congenital,
designated it in his later lectures as originating from want of use,
probably in order to advise the earliest possible performance of an
operation. There is no mention of his having brought forward evidence
for this assertion; that the great master himself said it was enough,
and the host of believers felt themselves to be the happy possessors of
a new dogma.
A number of children appeared in my practice, in whom congenital
cataract was needled by von Graefe in the first or second year of life
with recovery of transparent media, who showed, however, the extremest
degrees of defective vision when they were sufficiently intelligent to
have their vision tested. Whoever is interested in this can find a
number of such cases in the Royal Institution for the Blind at Steglitz,
which I am accustomed to visit several times a year by request of the
committee. On p. 91 I have related a case of monocular congenital
defective sight in congenital cataract of both eyes.
Everywhere then the principle holds good, that whoever makes an
assertion must be prepared to verify it; amblyopia from non-use is
denoted as an inherited trouble, and still not a single observation
exists which furnishes proof that an eye of previously ascertained good
visual acuteness has become amblyopic in consequence of disuse, a fact I
drew attention to ten years ago. Leber replies to this, he remembers "to
have seen patients with complete amblyopia in the squinting eye, who
stated that its visual faculty had been found to be good during an
examination instituted years before." Is this intended as an
observation? By that I mean is it a proof of facts, for the
trustworthiness of which he holds himself responsible: in the handling
of scientific questions I do not place the least reliance on the dim
recollections of unnamed individuals. Even in personally conducted
examinations we must be on our guard to avoid mistakes, and now we are
confronted with mere recollections of tests of vision!
By means of the above observations the theory that "the peculiar variety
of monocular amblyopia which is so frequent in monocular squint is
hardly observed without squint" is sufficiently disproved.
Public-domain text, read in full here on John Shaqi.
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