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To the Editor.
—Congratulations to Dr Zipf on his careful examination of fixation patterns in the diagnosis of strabismic amblyopia (Arch Ophthalmol 94:401, 1976).In his commentary he states that "children whose esotropia in casual vision measures at least 11δ and who demonstrate the fix grade of fixation preference may, with reasonable assurance, be diagnosed as amblyopic." I have been unable to determine how he reached this conclusion from the data that he presents. In Fig 6 of the article, there are 41 patients with esotropia of greater than 11δ without amblyopia, and of these, three have the "fix" grade. In Fig 7 there are 41 esotropes with amblyopia with an esotropia of 11δ or greater, and three show the "fix" grade of fixation preference. Since the incidence of the "fix" pattern is the same in both groups, there cannot be any significant difference. On the other hand, the number
Romano PE. Binocular Fixation Pattern. Arch Ophthalmol. 1976;94(9):1632. doi:10.1001/archopht.1976.03910040462034
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