A CONSIDERATION of the vertical component in strabismus involves a study of those complicated cases in which a vertical deviation is associated with a horizontal deviation. The complex manifestations of these cases present a special problem, and the difficulties arising from improper management can be very great, both to the patient and to the physician. Nowhere is experience more necessary than in the diagnosis and treatment of this condition.
As our knowledge of oculomotor defects has increased, we are more and more impressed with the important role of vertical defects in strabismus, especially those involving the oblique muscles. It is increasingly evident that a vertical defect in heterotropia is an important motor obstacle to binocular coordination; when associated with a horizontal deviation, it is frequently the true underlying imbalance, the horizontal deviation actually being a secondary phenomenon.
Lack of proper consideration of the vertical deviation has frequently resulted in disappointing
FINK WH. THE VERTICAL COMPONENT IN STRABISMUS. AMA Arch Ophthalmol. 1952;47(3):292-304. doi:10.1001/archopht.1952.01700030300004