This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
To the Editor.
—I wish to question, in one respect, the estimation of the loss of visual efficiency as drawn by the Council on Industrial Health of the American Medical Association. I refer to their statement that diplopia within the central 20° represents 100% loss of motility efficiency in one eye.I recently examined a patient in a medicolegal case for an insurance company. As a result of an automobile accident the patient apparently suffered a blow-out fracture of the left orbital floor, which tethered the inferior oblique so that elevation of the eye was severely limited. There had been no surgical intervention, and when I saw her five years after the accident, diplopia occurred in most of the upper binocular field, but also involved the central to about 15° below the horizontal. Thus her diplopia met the AMA Industrial Health Council's definition for 100% loss of motility efficiency in
Epstein E. Motility Efficiency. Arch Ophthalmol. 1984;102(6):825. doi:10.1001/archopht.1984.01040030651009