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November 1954


Author Affiliations


AMA Arch Ophthalmol. 1954;52(5):655-663. doi:10.1001/archopht.1954.00920050657001

IT IS THE purpose of this paper to show whether monocular or binocular squint surgery yields a higher percentage of comitance and, if possible, to show whether this factor materially influences the final results of treatment.

The thoughts inspiring this study were these: Since most patients with strabismus do not have a preexisting gross paresis or incomitance, any surgery should attempt to preserve this comitance. Further, monocularity or alternation usually is not influenced by "muscle strength or weakness," but, rather, is affected by ocular dominance, refraction, and amblyopia. Therefore, strabismus should be operated on only with due regard to alignment and preservation of muscle function, not with respect to whether the deviation is alternating or monocular. Finally, it seemed probable that if corresponding muscles in the two eyes were operated on at the same time, comitance could be maintained more easily than if the muscle lengths and insertions of only

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