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To the Editor:
—In the article "Binocular Refraction with Cross Cylinder Technic," in the January issue (Arch. Ophth.31:34, 1944), Major H. Saul Sugar champions the concept of "spherical equivalents" in dealing with anisometropia requiring a refraction in cases of high cylinder correction.Ordinarily, in the effort to secure minimal blur, the eye with a high cylinder error tends to utilize this device by focusing for the interfocal circle. If the static error is + 2.00 D. cyl., axis 90, the active eye accommodates 1 D. and thus converts its correction to − 1.00 D. sph. XXX + 2.00 D. cyl., axis 90. Even with cycloplegia some refractionists not infrequently correct for a confusion disk rather than for a point of focus if their routine is first to determine the sphere that gives the best vision and then to add the weakest acceptable cylinder. On the other hand, refractionists who consider
Lebensohn JE. BINOCULAR REFRACTION WITH CROSS CYLINDER TECHNIC. Arch Ophthalmol. 1944;31(3):268–269. doi:10.1001/archopht.1944.00890030097021
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