Biomedical subjects
Publications and source records attributed to E Stangler-Zuschrott.
It is shown from two examples that spectacle correction of minor grades of anisometropia in children can be sufficient to allow them to fuse normally and to avoid asthenopic complaints caused by partial suppression of the image from one eye.
Based on 15 case reports it can be shown, that the onset of a convergent squint is even possible in the age of presbyopia, independent of the patient's refraction. The clinical picture resembles that of a divergence paralysis or the convergent strabismus of the Bielschowsky type. In 13 cases the decompensation of a previous esophoria may have caused this distance-esodeviation; a divergence paralysis is not probable. In two cases change of orthophoria to esotropia could be observed. Therefore we share the opinion of v. Graefe, that an increased tonicity of the internal recti induced for compensation of weak convergence in aged individuals may cause esotropia. Treatment with prisms for distant vision is easy and effective. No case required surgery.
The valuation of 541 cases of convergent squint occuring together with a hypermetropia of more than +5 dpt showed that, the stronger the hypermetropia was, the higher was the proportion of primary microstrabismus to full-accommodative strabismus convergens. In patients who had hypermetropia of more than +8 D, the proportion of primary microstrabismus was 46%. Here the squint was always one-sided, so a high proportion of amblyopia could be expected. In 10% of the cases there was a spontaneous change from convergent to divergent squint - the angle reduction was up to 23 degrees, and could occur at any age. Factors, which seem to favour the appearence of a consecutive divergence, are: high hypermetropia of more than +8 D, increased ACA-ratio, onesided exclusion and vertical divergence. The measuring of the ACA ratio should be done at all orthoptic examinations.
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