In the reply to his critics G. Levinsohn1 repeats his assertions that myopia is due to the effect of gravity in the bent forward position of the head. The eyeball is said to protrude in this posture and to assume a pearlike shape, being similar to a bag of water suspended from a hook, the optic disk being the punctum fixum.
Indeed, the protrusion of the eyeball can be easily verified in many cases. However, this protrusion indicates a forward movement of the eyeball in toto and by no means an alteration of the shape of the eye. It is due to the congestion of the orbital veins. The extent of the protrusion depends on the size of the aperture between the lids, on the resistance of the orbital septum, ligaments, muscles and other structures and on the degree of filling of the orbital veins. If the protrusion were
LIPSCHUTZ H. MYOPIA AND ORBITAL CONGESTION. Arch Ophthalmol. 1936;16(2):255–256. doi:10.1001/archopht.1936.00840200093010
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