The transition from squint to the normal condition is formed by those
cases, in which the proper position of the eyes is maintained by a
desire for binocular single vision, while the elastic tensions of the
muscles are such, that squinting sets in as soon as binocular single
vision is rendered impossible (latent squint).
The squint is generally one sided (monolateral), for the eyes in this
case are usually of unequal value, and the best is always preferred for
use. The eye which has the acuter vision is always made use of when
something has to be carefully observed. But when the acuteness of vision
is equal, and one eye is emmetropic and the other hypermetropic, or if
both are hypermetropic but in varying degree, the most hypermetropic eye
is always the squinting one; for with a greater power of accommodation
it does not accomplish more than the emmetropic or less hypermetropic
one with slighter expenditure of strength. Why should a man strain his
accommodation when no advantage is thereby gained?
In most cases the squinting eye has also an available power of vision
and is on that account used for fixing objects which lie in the
direction of its visual axis; it can also be made to fix objects in
front, this occurs as soon as the other eye is covered; it remains as
the fixing eye till the next blinking of the lids, or movement to
another object for fixation, or till both eyes are closed for a short
time, when it returns to its former deviation.
A true alternating strabismus, _i. e._ alternate use of first one eye
and then the other to fix objects straight ahead, only occurs when both
eyes are of equal value as regards weakness and acuteness of vision, or
when one is more conveniently used for near, and the other for distant
vision. In these circumstances one eye is always short-sighted and is
used for near objects, while the other is emmetropic (or in less degree
near-sighted or long-sighted) and is preferred for distant things. The
reason for the alternation lies in the necessity for the act of vision
itself; it begins regularly whenever distant and near objects are
alternately fixed. Alternating squint is usually divergent, with short
sight on one side, still convergent strabismus may occur under these
conditions.
CONVERGENT SQUINT
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