A white man aged 48, who apparently was in good health, registered in the Section on Ophthalmology of the Mayo Clinic on Sept. 16, 1936, for refraction. The glasses he had worn for the preceding four years had been broken recently, but the lenses, while they had enabled him to carry on his duties as a railroad station agent in a small community, never had provided him with satisfactory, comfortable vision. Refraction had been done many times by numerous ophthalmologists and by nonmedicai refractionists. He still possessed twenty-five pairs of glasses, none of which was really useful. Poor visual acuity had been present since early childhood, but asthenopia never had been a prominent symptom. There was no history of infection or injury of the eyes, nor was there any family history of ocular disease.
The external ocular examination revealed facial asymmetry of moderate degree. There were slight flattening of the