There are sins of omission as well as sins of commission in every profession. Oculists are guilty of the former when they treat asthenopic symptoms as though all were accommodative and none muscular. This paper does not aim at bringing out anything new in the way of diagnosis, or treatment, but simply recommends the necessity of determining the muscle balance in all refraction cases, and emphasizes a known and tried method of relieving the vast majority of cases in which exophoria exists. This subject has been impressed on me by seeing numerous cases that have passed through the hands of competent oculists, wearing glasses practically correct, with asthenopic symptoms unabated because of an unsought for and unrelieved exophoria.
I wish also to sound a note of warning against the indiscriminate performance of the various tenotomies, with or without advancements, wherever imbalance is found. While not opposed to operative measures when
ROBERTS WH. THE CORRECTION OF EXOPHORIA BY DEVELOPMENT OF THE INTERNI. JAMA. 1905;XLV(7):439–442. doi:10.1001/jama.1905.52510070007002
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