CASE 41.--Miss A. L--, æt. 27, is stated to have commenced to squint in her first year, until at the age of eighteen she took pains to cure the habit, and with perfect success as far as regards the position of the eyes; the only disagreeable symptom was that she could no longer read with the naked eye. Spectacles were therefore prescribed for her, convex 5 D., but even they did not quite remove the trouble in reading; it was now a disagreeable, painful sensation to have recourse to squint in order to see more clearly. It was easiest to read with greatly lowered field of vision and with the help of a convex eyeglass as well as the spectacles. During the examination I found on the right hypermetropia 5·5 D., visual acuteness 5/12 to 5/9, on the left with + 5·5 D., V = 1/12. With convex 6 D. No. 0·5 was read at 12 inches from the glass, but not nearer, with normal fixation on both sides. The binocular near point (if we may employ this expression in the absence of normal binocular fusion) was considerably removed without the existence of paresis of the accommodation, despite the over-correction of the hypermetropia. It was rather a question of the same disposition of the relative amplitude of accommodation as I have previously described in a similar case. By methodical practice of binocular vision, I had taught an intelligent boy to fix binocularly, not only for distance, but also for near objects, but here again the relative amplitude for accommodation was diminished, so that with correct binocular fixation he could only read with convex glasses, which greatly over-corrected the hypermetropia. Finally, the normal amplitude of accommodation was restored by tenotomy of the left internal rectus, and when I saw the patient twelve years later I was able to satisfy myself that both were perfectly preserved. In the case of Miss L--, I believed I ought to give up all thoughts of an operation; the position of the eyes could not be improved, convex 5·5 D. eyeglass perfectly sufficed for distance, and convex 7 D. spectacles for reading. It seemed to me senseless to perform tenotomy merely to enable her to use the same glass for distance and for near objects, without any possibility of a cosmetic improvement. Moreover the condition of binocular vision quite confirmed the statements as to the previous squint. Diplopia could only be produced now and then with the help of prisms and red glass, at first the right visual field only was seen in the stereoscope, on closer observation also the left, but without binocular fusion. Besides, the proved decrease of the relative power of accommodation in both these cases, marked by a voluntary suppression of the squint, does not appear in those cases where squint disappears of itself, the state of the accommodation, therefore, shows nothing unusual.