On the etiology and treatment of convergent squint.

  • Snell, Simeon, 1851-1909.
Date:
[1887]
Catalogue details

Licence: Public Domain Mark

Credit: On the etiology and treatment of convergent squint. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    ON THE ETIOLOGY AND TREATMENT OF CONVERGENT SQUINT. The frequency with which advice from each of us is sought respecting cases of strabismus, and the large numbers of such cases that pass before us, render the subject of our discussion both interesting and important. At different times many distinguished men have be- stowed upon it great labour ; and, whilst much of our information respecting strabismus is of an accurate character, on the other hand there are still points requiring elucidation, and matters in dispute needing settlement. The subject for our discussion is, however, so wide that, within proper limits and with a due regard to your patience, it will be quite impossible for me to deal completely with it. I must, therefore, con- tent myself with traversing the field as well as I can, feeling confident that my omissions or deficiencies will be made good by the many dis- tinguished confreres who will follow. It is hardly questioned, I think, that a close relation exists between strabismus convergens and hypermetropia. The frequent association of the two is a standing proof of some relation. It has been asserted that hypermetropia is present in 95 per cent, of the cases of internal squint ; and this number may be enlarged by adding thereto many of the cases with corneal nebulae, which are also hypermetropic. Hirschberg asserts that such eyes are hypermetropic, and that without this condition they would not squint. In the cases coming for treatment, emmo- tropia is rarely met with, and in the large number of convergent squints I have seen I recollect only three associated with myopia. It is also generally held that the degree of hypermetropia associated with squint is neither the high nor the low, but the medium. This has been the opinion held from Donders onwards, and explanations have been given to show why in the high and low degrees squint is less frequently found. The view held is, I believe, generally correct ; but I think it may be stated in another way. A considera- tion of my squint operations showed that by far the greater number were performed on patients between the ages of 6 and 18 (inclusive), and in the Infirmary books was a total of 285 operations between these ages. Comparing the degree of hypermetropia in these cases with that present in 200 instances within similar limits of age, who had come under treatment simply for their refractive condition, it was found that the average degree of hypermetropia in each class was very closely alike, the former yielding an average of nearly 4.25 D, and the latter a fraction higher. There appeared more tendency to rise above the medium degree of hypermetropia than to pass to the lower. ) o n /\ u~