Strabismus Symposium Amsterdam, September 3–4, 1981

275 Pages·1982·22.29 MB·English

by  A. Th. M. van Balen, W. A. Houtman (eds.)

Strabismus Symposium
Documenta Ophthalmologica
Proceedings Series volume 32
Editor H.E. Henkes
Dr W. Junk Publishers The Hague-Baston-London 1982
Strabismus Symposium
Amsterdam, September 3-4, 1981
Edited by A.Th.M. van Balen
and W.A. Houtman
Dr W. Junk Publishers The Hague- Boston- London 1982
Distributors:
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Library of Congress Cataloging in Publication Data
Strabismus Symposium (1981 : Amsterdam, Netherlands)
Strabismus Symposium, Amsterdam, September 3-4, 198L
(Documenta ophthalmologica. Proceedings series ;
v. 32)
L Strabismus--Congresses. 1. Balen, A. Th. M. van.
II. lioutman, W. A. III. Series. [DNLM: 1. Strabismus--
Congresses. W3 Do637 v. 32 1981 I WW 415 s896s 1981]
RE77L s85 1981 617.7 f 62 82-16
AACR2
ISBN-13: 978-94-009-7999-4 e-ISBN-13: 978-94-009-7997-0
001: 10.1007/978-94-009-7997-0
Cover design: Max Velthuijs
Copyright © 1982 Dr W. Junk Publishers, The Hague.
Softcover reprint of the hardcover 1s t edition 1982
All rights reserved. No part of this publication may be reproduced, stored ill a retrieval
system, or transmitted in any form or by any means, mechanical, photocopying,
recording, or otherwise, without the prior written permission of the publisher.
Dr W. Junk Publishers, P.O. Box. 13713, 2501 ES The Hague, The Netherlands.
CONTENTS
Opening of the symposium
by the President C. Clippers 1
PART ONE: BINOCULAR VISION AND CONCOMITANT SQUINT
Physiological ftxation disparity
by C. Rashbass 3
Fixation disparity and the interaction of foveal and non-foveal fusion
by W. Russman and C. vom Eyser 11
Fixation disparity in vertical vergence movements
by W.A. Houtman and B.A.E. van der Pol 17
Vertical ftxation disparity and stereopsis
by J.B. Weiss 29
461 Curves of horizontal prism ftxation disparity in an orthoptic
department
by R.A. Crone and AM. Noordenbos 35
Anomalous fusion
by B. Bagolini 41
Sensorial interactions in reeducated strabismic amblyopia
by M. Focosi, G. Salvi and R. Frosini 53
Binocularity in comitant esotropia and exotropia
by E.C. Campos and C. Chiesi 55
Results of the fadenoperation in alternating convergent strabismus of the
congenital type
by W. de Decker and W. Haase 65
Possibility of correct fusion formation of adults
by T. Baranowska~eorge 73
Early onset esotropia
by B. Harcourt and J. Mein 79
A new hypothesis on latent nystagmus and on the congenital squint
syndrome
by J. Lang 83
Strabismus in cerebral palsy
by K. Wybar 87
v
Comparative study of the anaesthesia test in normal and strabismic
children
by M.A. Zato, J.e. Castiella and J. Garcia sanchez 89
Unilateral traumatic aphakia
by J.R. Pameijer 95
Motor tonus adaptation in squint
by S. Rethy and S. Gal 101
The subjective angle as a basis for the surgery of the anatomical
deviation
by A. Spielmann 107
Influence of progressive press-on-prisms on changing squinting angles
by H. Aichmair 113
Binocular vision in treated squints
by F. Polychroniadis and S. Polychroniadis-Scouros 119
Causes and treatment of consecutive exotropia
by M.H. Gobin 123
Posterior fixation surgery in paretic strabismus indications and technic
byW. de Decker 131
Results of Clippers Fadenoperation (posterior fIxation suture)
by H. Kaufmann 143
PART TWO: NON-COMITANT SQUINT
Basic motor mechanisms in paretic squint
by G. Kommerell 149
Primary overacting inferior oblique muscle
by K. Mukuno, K. Furuno, H. Yoshida and S. Ishikawa 159
Electrooculographic examinations in comitant and incomitant strabismus
by V. Dorn and M. Celie 163
Electrophysiological diagnosis in non-comitant strabismus
by R. Frosini, M.C. Boschi and D. Baroncelli 173
The Bielschowsky head tilt test and ocular counter-rolling
by J. van der Meer 179
L'electro-oculographie des paralysies oculo-motrices horizontales interet
physio-pathologique, diagnostique et therapeutique
by M.A. Quere, A. Pechereau and F. Lavenant 185
The treatment of non-comitant strabismus
by P. Fells 197
Use of adjustable suture technique in surgical management of non-
comitant squint
by J. Sjostrand 209
Duane's retraction syndrome: Diagnosis and therapeutic considerations
in 150 cases
by K. K zystkowa, J. Pajakowa, C. Bilska and J. Pyzowski 215
La chirurgie du grand oblique
by J.e. Castiella, 1. Orbegozo, M.A. Zato and G. Castiella 221
VI
Considerations on the surgical management of isolated oculo-motor
palsies
by M. Deller 229
Surgical symmetrization of kinetical incomitances
by G. Salvi, R. Frosini and M.C. Boschi 233
Retro-equatorial myopexy of the vertical recti in traumatic diplopia
by L. Koornneef, R.A. Crone and AM. Noordenbos 237
L'arrachement et la migration anterieure du ftl dans la Fadenoperation
de Clippers
by A. Pechereau and M.A Quere 243
Oculomotor imbalance in congenital ptosis
by A. Castanera Molina, A. Castanera Pueyo, J. Castanera Molina
and F. Castanera Molina 249
Die Bedeutung der Vertikalablenkung bei der horizontalen Blicklahmung
by H.F. Piper 253
Prenuclear slowly progressive bilateral abducens palsy in Marie's cerebellar
ataxia
by T.W. van Weerden and W.A. Houtman 263
Absence or hypoplasia of extraocular eye muscles
by W. Konen and W. Riissmann 269
Posterior fixation suture in noncomitant squint. Round Table Discussion 275
VII
OPENING ADDRESS
Ladies and Gentlemen, my dear colleagues:
The meeting of the CESSD in Amsterdam has been opened. Maybe this will
be the last meeting in its present form. A transformation is taken into con-
sideration. Well, it is an astonishing coincidence that this event is to take
place in this year and in this country. As regards the time, it is now exactly
twenty years ago since the CESSDwas founded in Paris, namely in the autumn
of 1961. As regards the place, the Netherlands, a decisive impetus to the
foundation of the CESSD was given by a Dutchman, namely by our colleague
Mr. Jonkers.
I suppose that a vast majority of the participants in this meeting do not
know, be it for reasons of age, the way that led to the foundation of the
CESSD. In order to prevent this fact from leading to false ideas concerning
the original meaning and purpose of the organization (which, in my view, too,
needs reforms) I am going to take the liberty of taking a short look back at
the history of the association.
After the last world war, the ophthalmologists on the European continent
who were particularly interested in the problems of strabismus formed an
infmitely small group. Switzerland was, to a certain degree, an exception, not
the least thanks to the work of Bangerter, and it was, therefore , not a matter
of pure chance that owing to an initiative taken by Streiff, stabismus was the
main subject of the 1955 meeting of the Schweizer Ophthalmologische Gesell-
schaft. The meeting was a fruitful one, in all respects, and offered the first
opportunity for an exchange of ideas on the continental level.
On the other hand, the 1958 international congress of ophthalmologists in
Brussels, from which quite a number of people had expected much, was, to a
large extent, as regards strabology, a failure, although strabismus was one of
its main subjects. There were numerous reasons for that failure, let me just
point out one of them, namely the fact, clearly recognized at the time by
Jonkers, that a decisive impediment to productive cooperation, in particular
with Anglo-Saxon colleagues, had resulted from the fact that we had neither
a uniform terminology nor uniform diagnostic methods with common funda-
mental principles. To put it exaggeratedly: We were discussing with one
another without being sure that we understood one another.
Through the endeavours of several years, Jonkers succeeded in getting
Docum. Ophthal. Proc. Series, Vol. 32, ed. by A. Th.M. van Bolen & W.A. Houtman
© ] 982, Dr W. Junk Publishers, The Hague. ISBN 978-94-009-7999-4
colleagues who were interested in the problems to join up and form a group.
Later on, the members of that group were appointed official representatives
by their respective national ophthalmological societies. The CESSD was thus
officially founded in the autumn of 1961, under the direction of Jules
Fran<;:ois. Its task consisted in co-ordinating, within a small group on a Euro-
pean level, problems of strabology and in passing the results on to national
working parties, which were taking shape more and more everywhere. Those
activities were completed by regular meetings on the European level, partly
held, intentionally, without dependence on general ophthalmological con-
gresses, somewhat in the style of today's meeting.
From the very beginning, the CESSD called itself a European organization,
but that was not true, it being, in the first stage, limited to Western Europe.
The credit goes to Thomas, who thanks to his personal contacts with the
World Health Organization, created the possibility of the CESSD being joined
by representatives of the so-called socialist countries in 1964. Our colleague,
Avetisov, of the Moscow Helmholtz Institute became one of our vice-presidents.
The sole exception has been up to now, as far as I know, Albania.
This all-European union has been not only a theoretical construction but
has withstood many a strain in spite of the political situation that was difficult
at that time, too. Numerous colleagues from the other side of the 'Iron
Curtain' were in this way offered the possibility of taking part in meetings
held in the West for the first time, for example in the 1966 symposium at
Giessen.
Vice versa, it was also possible to hold a symposium in 1968 in Leipzig
that was harmonious in all respects under the direction of Sachsenweger,
despite the entry of troops into Czechoslovakia.
Ladies and Gentlemen,
When presenting you with the historic evolution of the CESSD, I was induced
to do so for several reasons. First, because I felt bound to give, here and now,
our colleague Mr. Jonkers, our thanks for his contributions. Secondly, I did it
for the sake of rectifying false notions. The CESSD has never been a Strabo-
logical Society in the usual meaning. I for my part, at least, have always, since
its foundation, seen it as an all-European committee charged with the task of
creating contacts for mutual understanding and endeavouring to achieve
harmony. The fact that, in addition, symposiums with general admission have
been organized by the respective national representatives does, in my view,
not change the fundamental structure. If we want to keep to that task, we
have to question ourselves as to what is the most suitable reform of the
CESSD for pursuing that aim. With good will on all sides, we shall certainly
find a solution.
Irrespective of the said problem, I wish you full success for your work
within the framework of this meeting. I thank you very much for your
attention.
C. Clippers (president)
2
PHYSIOLOGICAL FIXATION DISPARITY
C. RASHBASS
(Groningen , The Netherlands)
INTRODUCTION
Any dialogue between physiologist and clinician introduces the risk of lang-
uage difficulties, and these are somewhat different from the language difficul-
ties at any European meeting. The latter arise from a desire to use different
words to express the same ideas, but the problem when physiologist confronts
clinician is the wish to use the same words for different concepts. In order
to try to avoid such misunderstandings some clear definitions are needed at
the outset.
The fundamental concepts that are used in talking about the eyes' ver-
gence control system are 'vergence' , 'target vergence' and 'disparity'. These are
defmed in Fig. 1. 'Fixation disparity' is a disparity present during the steady
binocular fixation of a target. The question of physiological interest is whether
fixation disparity needs to be- non-zero in order to maintain the state of ver-
gence of a person with a well-developed, healthy vergence system, when view-
ing a target situated at any distance within the range of distances at which
binocular viewing is unstrained. The most complete studies of the vergence
control system fail to answer this question satisfactorily. Westheimer &
Mitchell (1956) reported a substantial fixation disparity but Rashbass &
V: verg.nce
T: ta rget vergenc e
o : T - v : disparity
Fig. 1. Illustrates the defmition of the primary terms : vergence (v): the angle of intersec-
tion of the lines of sight ; target vergence (t): the vergence that would obtain were the
lines of sight directed through the target; disparity (d) : the difference between vergence
and target veI2ence.
Docum. Ophthal. Proc. Series, Vol. 32, ed. by A. Th.M. van Salen & W.A . Houtman 3
© J 982, Dr W. Junk Publishers, The Hague. ISBN 978-94-009-7999-4