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To the Editor.
—The article by Sprague et al illustrates the drawbacks of overspecialization. Pediatric ophthalmologists are necessary, but the faden operation espoused for the treatment of DVD points up the danger of not seeing adult patients. The article says that "contrary to popular opinion, time does not improve DVD." No statistics or studies are cited as basis for this statement. Yet DVD is rarely, if ever, seen in adults. Most ophthalmologists do not check for DVD in adults. That it is not seen in adults means either that it is not present or that, if it is present, it is not cosmetically unacceptable.The article ends by saying, "Our favorable results with the faden operation for DVD are in keeping with other reports in the literature." So it is with all operations with defects seen in children that clear with adulthood. In actuality, the favorable results would occur with
Fleming AW. Dissociated Vertical Deviation. Arch Ophthalmol. 1980;98(11):2083. doi:10.1001/archopht.1980.01020040935032