Crossed diplopia with a difference in height is distinguished with the
aid of a red glass, the difference being corrected by a prism of 4°,
with the base downwards before the right eye; a prism of 4° with the
base inwards suffices to place the double images immediately above one
another. Spontaneous diplopia does not take place; only the right visual
field is seen in the stereoscope. As patient lived in Brandenburg and
only came to consult me occasionally I never had an opportunity of
seeing the squint till she decided to stay here for some time. It was
then seen that a peculiar oscillating deviation of the left eye of about
4 mm. inwards often occurred. As the previous spontaneous disappearance
of the squint and the crossed diplopia made one fear that tenotomy of
the internus might be followed by divergence, instillations were used in
order to make a more exact measurement of the deviation,--by this means
the condition was so improved in the course of a few weeks, that
deviation no longer occurred even on exclusion of the right eye.
The spontaneous cure of squint may, however, be quite complete; indeed I
have seen one case where convergent squint became divergent.
CASE 40.--A young lady, slightly over twenty years of age, showed on the
right M. ·75 D., V = 10/10, on the left H. 1·5 D., V. 10/40 to 10/30,
and slight divergent squint on the left side. Crossed diplopia could be
produced with a red glass, tenotomy of the left abducens sufficed to
correct it. I had not concealed my doubts as to her statement that she
had previously squinted inwards, but they were quite dispelled by a
photograph taken about twelve years before, in which decided right
convergent squint could not be mistaken. There is something to be said
for the fact that it may have been a periodic squint, which occurred
during the taking of the picture, as the photographer would have taken
pains to hide a permanent squint in some way.
Conscious suppression of squint happens now and then, although very
rarely.
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