A comparison of the left eye shows adduction of 18 degrees with an
abduction of 8 degrees, proving a lateral insufficiency because the
ratio is less than 3 to 1; and the muscles of the left eye are at
fault. The power of 2 degrees superduction and 2 degrees subduction,
proves that no weakness exists in the vertical muscles.
After making the duction test for each eye individually, a comparison
of both eyes in relationship to each other may be more readily
determined by following the dotted lines (Fig. 24).
As previously stated, it is the inability of the two eyes to work
together that causes the imbalance, so that if both eyes were normal,
the adduction, abduction, superduction and subduction of the two eyes
would agree.
The duction chart (Fig. 24.) also shows that the corresponding muscles
of each eye agree—with the exception of the adduction of the right eye
and the left eye. This proves that the left internus is weak, measuring
only 18 degrees instead of 24 degrees; it further proves the 6 degrees
of exophoria in the monocular test, as was quickly and more readily
determined in the binocular test.
Likewise, in cases of esophoria, hyperphoria, or cataphoria, the making
of definite muscle measurements independently through the prescribed
method would show through the merest glance at a similar diagram which
muscle or muscles were relatively out of balance. Heterphoria of almost
any type, or tendencies other than normal, may be fully investigated by
making a thorough and separate test of each muscle.
Where an imbalance exists, a rapid test may be employed to distinguish
a pseudo or false condition from a true condition. This is accomplished
by first placing the two Maddox rods (both the red and white) so that
the rods lie in a vertical position. If the two lines fuse, we have
determined the existence of a false condition caused by a possible
error of refraction or nerve strain. If the lines separate, we have
determined a true muscular condition, and then only should the second
method of muscular treatment follow.
[Illustration: _Same as Model 215 but Automatic Cylinder Arrangement
omitted._
SKI-OPTOMETER MODEL 205
Embodying Spherical Lenses Combined with Appliances for Testing and
Correcting Muscular Imbalance.]
CHAPTER IX
FIRST METHOD OF TREATMENT OPTICAL CORRECTION
The mere determination of the degree of an imbalance, or even the
diagnosis of a patient’s trouble, is not sufficient. If relief is to be
secured, something more must be accomplished.
As previously stated, muscular imbalance may be corrected through
one of the four following rules or methods, each explained in their
relative order:
1—Optical Correction
2—Muscular Exercise
3—Use of Prism Lenses
4—Operative Methods
ESOPHORIA
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