Insufficiencies of the oblique muscles and how to correct them / by G.C. Savage.

  • G. C. Savage
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Insufficiencies of the oblique muscles and how to correct them / by G.C. Savage. 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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    My records for the past two years show a number of cases of symmetrical insufficiency of the obliques, to all of whom I stated : ‘ for this condition I can do nothing.” The condition is real, the treatment is rational, and relief must follow. The condition is easy of detection and the insufficient muscle can be quickly located. The double prism before the right eye, the middle line is seen by the left (the one under test); if it dips towards the opposite (right) side the superior- oblique is insufficient (see Fig. 1), if towards the same side the inferior oblique is insufficient (see Fig. 2). The same is true when the right eye is under test as is shown in Figs. 3 and 4. In the treatment either concave or convex cylinders can be used ; if the concave are used and the insufficiency is in the superior obliques tlfe axes must be placed in the lower nasal quadrant, if in the inferior obliques then the axes must be placed in the lower tem- poral quadrant. If for the exercise the convex cylinders are chosen the axes must be placed in the lower temporal quadrant for insufficiency of the superior obliques and in the lower nasal quadrant for insufficiency of the inferior obliques. In either case the effect is increased as the axis is made to move from the vertical to the point of maximum effect which is 45° from the vertical. The exercise may be commenced with a .50 to a 1.00 D. cylinder, and increased each day a .50 D. up to 3.00 D. The cases will be very rare that will require a stronger exercise prio-ro than the last named. The graduated exercise should be con- tinued daily. Each eye being affected, the exercise cylinders should be placed before both.