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Article
September 1938

NATURE AND MANAGEMENT OF THE HETEROPHORIAS

Arch Ophthalmol. 1938;20(3):375-383. doi:10.1001/archopht.1938.00850210031004

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Abstract

At birth the eyeballs assume a position controlled by basic innervation which is present before environmental influences have become effective. This innervation is innate and has been called tonic innervation. At birth vision is not fully developed, nor is the relation between the two eyes developed. As growth proceeds, fixation, fusion, coordination, convergence and accommodation develop, become interrelated and assume their various roles in the positioning of the eyes. When the higher centers of the brain are inhibited, as in sleep, deep narcosis or coma, the eyes may assume a position which is irrelevant to that in effect when the nervous system is functioning normally. In fact, it seems from the positions of the eyeballs under the conditions named that the eyes are more or less set adrift to wander with little or no innervational control. With the return to normalcy, a flow of properly distributed innervation

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