The letter of Dr. G. M. Howard "A-V Syndromes" published in the May issue of the Archives of Ophthalmology was referred to the author of the paper in question, who offers the following reply.
To the Editor.
—Dr. Howard feels that the attempt to explain the A-V syn dromes on the basis of underaction or overaction of one pair of extraocular muscles is unsatisfactory in the light of vector analysis computations and the anatomy of the extraocular muscles. Furthermore, he concludes that as the result of these factors, horizontal muscles must contract and enter into vertical movements of the eye in order to avoid severe adduction due to the overpowering adducting ability of the vertical recti, as compared to the obliques.Though based on careful anatomic dissection and sound mathematical computations, Dr. Howard's conclusions are nonetheless theoretical and raise further questions since they are not borne out by the following
Tamler E. A-V SYNDROMES-Reply. Arch Ophthalmol. 1962;68(1):153–154. doi:10.1001/archopht.1962.00960030157035