CASE 37.--Miss H--, governess, æt. about 30, came under treatment for
asthenopic disorders; on both sides hypermetropia 2·5 D., visual
acuteness 5/18. She owns to have squinted as a child,--it had often been
remarked when she was at school. The squint gradually disappeared, but
still occurred sometimes on keen fixation. The usual position of the
eyes appears perfectly normal, and gives no suspicion of squint;
convergence occurs on exclusion, sometimes with downward deviation of
the right eye. With the aid of a red glass changing fixation is easily
produced even without prisms, but never diplopia. At first only the left
visual field was seen with the stereoscope; then the right on exclusion
of the left eye; never both at the same time. According to this the
condition of binocular vision speaks entirely for the fact, that squint
had existed long enough to prevent the development of a normal binocular
visual act, and the squint had disappeared without the help of convex
glasses in spite of the hypermetropia.
CASE 38.--Bertha W--, æt. 18, reads with the naked eye on the right No.
0·75 at 10 cm., on the left only 1·75 at the same distance;
hypermetropia of 6 D. is detected with the ophthalmoscope, with + 5·5
the visual acuteness of the right eye amounts at 1 metre to 1/9 (if the
test-letters had contained No. 8 or 7·5, that would probably have been
recognised also), on the left with + 5·5 D., V. = 1/12, with + 6 D. No.
0·8 is read with difficulty. Patient admits to have squinted as a child;
no squint is present now; binocular fusion can be detected with prisms
and she only squints now and then on the left side to assist vision,
with which, patient states without being questioned, diplopia is
combined. Spectacles have not been used till now.
I could cite several more such cases, but they would prove no more than
these. At any rate the fact is settled that squint can disappear
spontaneously, and without the aid of convex glasses even in high
degrees of hypermetropia.
Wecker's announcement that "this spontaneous cure goes hand in hand with
the progressive decrease of the accommodation, and depends on the fact
that the squinter, on the strength of this progressive decrease,
renounces more and more the aid which he finds in the increased
convergence during the act of accommodation," only proves to how great
an extent one may be prejudiced by theories. A limitation of the
accommodation must necessarily increase the claims which are made on it,
and can only afford inducement for calling forth all the help possible
to support the accommodation.
Public-domain text, read in full here on John Shaqi.
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