The non-operative treatment of strabismus / George M. Gould.

  • Gould, George Milbrey, 1848-1922.
Date:
[1902]
Catalogue details

Licence: In copyright

Credit: The non-operative treatment of strabismus / George M. Gould. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    D becomes our highest obligation. The best method of ed- ucation as to strabismus consists in demonstrating the fact by prevented and cured eases, that operation is not necessary. Every good oculist has hundreds of happy patients who have no deformity and who have binocular vision—so long as their spectacles are in place. Eaise the lenses and instantly there is strabismus! That is a demonstration convincing to every one. I know of no more heinous sin of ophthalmologists than one that has been and still is revealed almost every day in my prac- tice, the sin of telling parents that operation will be re- quired but not before the child is seven or nine years old. At that late age, generally speaking, irreparable injury may have been done. The neglected hyperopia, astig- matism, or anisometropia may have produced the irreme- diable amblyopia, loss of innervation, psychic suppres- sion of the image of one eye, etc. I am not supposed to go into the question of the cause of strabismus, but, as all my treatment is based upon a theory, I may say that for all practical purposes, i._ e., with unimportant exceptions, in the cases under discussion the poor abused muscles and tendons are not abnormal as a causal agency. All ‘‘myolog}'^^’ resolves itself, of course, into neurology. The incoordination of innervation which causes all heterophoria and strabismus is a functional disease, and is caused by the fact that the peripheral organs are so optically dissimilar and de- fective that binocular vision is impossible. Anisome- tropia and astigmatism are the initial sources of the im- possibility of binocular vision, in the vast majoritv of eases. I should premise that the foregoing statements require some self-evident exceptions which not only test, but oftp prove the rule. I except traumatic strabismus (in which class I include strabismus, the result of operation), paralytic strabismus, most cases of alternating strabis- mus, and some anomalous cases that defy all rules of diagnosis and treatment. But even in these no operation IS usually advisable. The non-operative treatment of strabismus naturally divides itself into: 1. Prophy]a.xi8. 2. Tlie treatment of ametropia. 3. The treatment of heterophoria.