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R Pigassou-Albouy

Publications and source records attributed to R Pigassou-Albouy.

At least 19 recordsLinked to original sources
PubMed1986

[Primary intermittent exotropia and its treatment].

After reviewing literature concerning IE, the following conclusions can be pointed out. The IE is a mild form of strabismus, provided that all the disturbed parameters, especially the processes on inhibition, should be involved in the treatment (in this case, prism looks to be the best method because of its efficiency all day long and because it does not force the patient to exercises more or less tedious.

Accommodation, Ocular↗
PubMed1984

[Accommodation in strabismus].

This paper describes clinical observations of optico-sensori-motor symptomatology prior to and during treatment for strabismus. These findings were compared with theoretical data of the binocular visual function. We consider that binocular function has the structure and the working of a "set" in cybernetic sense. In this psycho-physiological set, the accommodative system constitutes a "sub-set". The classification of accommodative disturbances as "pure or impure" and "typical or atypical" arises from the fact that a rebuilding of the visual function has occurred. Thus in "pure" accommodative strabismus the disturbances of accommodation results from "peripheral" accommodation and is easily reversible. In this situation ocular deviation has been perfectly corrected for and binocular vision normally built up since there is enough compensation of the whole optical correction. In "impure" accommodative strabismus the perturbation of accommodation affects the whole accommodation system and also the sensorial motor system. Thus there is a restructuring of the optico-sensori-motor set that is more or less reversible due to a variety of factors. From these investigations we conclude: every strabismus is accommodative in the sens that in every strabismus there is a disturbance of accommodative mechanism. Furthermore, we oppose believers of "all sensorial" and "all motor" mechanisms. Considering that strabismus is a disturbance of optico-sensori-motor binocularity, nothing can be only "accommodative", only "sensorial" and only "motor". From this it follows that treatment should not be only "motor", only "accommodative" or only "sensorial".

Accommodation, Ocular↗
PubMed1983

[Functional treatment of strabismus: theoretical bases--practical rules].

Functional treatment of strabismus is no longer empirical, but has currently a scientific basis. To disperse the "doubts" surrounding functional treatment, it appeared necessary to situate it more clearly within its true framework, that of functional re-education in general. Indeed, although the terrain differs adults with a lesion and children whose binocular function is poorly or only partially developed - in both cases: - functional recovery is the result of changes within the central nervous system, changes which are possible due to the plasticity of the central nervous system. These modifications occur very slowly, sometimes over a period of years. - The crucial condition for success of treatment remains the same: the patient must participate actively, this being all the more essential in that recovery will take a long time. Although strabismus treatment must obviously consider physiological parameters (triad), psychological parameters are just as important, and as well as purely technical problems, other factors must also be taken into account: subject's motivation, length of treatment, communication with the doctor and medical team, attitude of the patient's family. This type of therapy is only justified as long as strabismus is considered to be a dysfunction of binocularity (this however, does not exclude surgery in some cases, and the operation is an integral part of the treatment). Functional treatment of strabismus is therefore difficult and disconcerting for the practising ophthalmologist. Disconcerting in that it differs radically from other types of eye therapy (medical or surgical); difficult in that the restraint it imposes is often in contradiction with the permissive society we live in. One of the main obstacles to be overcome is perhaps our own judgement as ophthalmologists; our opinion of the nature of strabismus, the possibility of a cure, to which must be added the application of the right technique, patient participation, etc. This study attempts to situate strabismus within the general framework of functional re-education, employing different authors' opinions of basic notions of neurophysiology relating to nervous plasticity and their application in cases of cortical lesions in adults. In Part II we shall outline why and how we have opted for functional re-education. The reasons why and the manner in which functional re-education was chosen are then outlined.

Age Factors↗
PubMed1980

[The mechanism of inhibition of binocular vision in convergent strabismus (author's transl)].

The mechanism of inhibition of binocular vision (at a cortical level in the Pavlovian sense) in convergent strabismus is described. The study concerns both those patients whith no amblyopia and those whose amblyopia has been cured. Part one of the article describe the clinical characteristics of this cortical inhibition as shown by the polarised light stereoscopic projector. Some basic concepts with this therapeutic application are described in part two. In this paper the author suggests a relationships between the severity of inhibition of binocularity and the degree of disturbance in spatial localisation. The greater the inhibition at a cortical level, the more disturbed is the localisation of objects in space in binocular vision. The treatment of inhibition must include precipitating causes that is to say the disturbed binocular relationships of abnormal retinal correspondence and is complete when cortical inhibition and abnormal retinal correspondence has been completely rectified. On the other hand there are occasions when it is not possible to eliminate abnormal retinal correspondence, this is especially true in older patients, and under this circumstances, it is better to accept inhibition of binocular function than to have diplopia.

Diplopia↗
PubMed1980

[Sensory binocular relationships in divergent strabismus and convergent strabismus].

The adaptive processes mentioned here (which include inhibitory phenomena and modifications in spatial localization) were observed, using a stereoprojector which polarized light. Comparing the adaptive processes in convergent and divergent strabismus has led to the following observations: (1) there are differences between the two types of strabismus; these differences appear not only at the level of the binocular sensory parameter but also at the level of motor and accommodative parameters; adaptive processes are less deep and less serious in divergent and strabismus; these differences are also manifest in therapy: divergent strabismus is curable whatever the age, treatment is much shorter. These observations were the starting point for using prismatic overcorrection to induce a state of 'sensory divergence' as treatment in cases of convergent strabismus with anomalous retinal correspondence. The excellent results obtained using this method of treatment are not only due to the action on sensory binocular relations, but also to the fact that prismatic overcorrection also modifies abnormal motor patterns. Treating strabismus must involve the entire disturbed optico-sensorimotor complex.

Accommodation, Ocular↗
PubMed1979

[Eye-hand coordination in squint sufferers].

The localisation of an object close at hand and grasping it with the hand is the result of a complicated sequence of nerve impulses involving close co-operation between optical, perceptive and psychological stimuli, which are integrated in the central nervous system and lead to a well-directed command-movement. Disturbances of coordination between eye and hand in cases of amblyopia and concomitant strabismus are described. The individual authors suggest different forms of traeatment. In our opinion these are not genuine disturbances of hand-eye coordination. In amblyopia we have an ambiguity of localisation due to fact that the fixation is not stable. In the case of strabismus the error of spatial localisation can be explained by the unnatural examination methods, and by the abnormal position of the eye in the orbit. There is no denying the results gained by localisation treatment, but these the results can also be achieved by another mechanism not only in amblyopia but also in strabismus.

Amblyopia↗
PubMed1977

[Strabismus and pseudostrabismus (author's transl)].

The method of clinical examination on binocular sensory-motor connection used in the children of less than three years of age for early detection of strabismus, is used in cats. A number of common and Siamese cats were examined under the same conditions. The clinical results lead to the following conclusions: -- Contrary to general opinion, Siamese cats do not show strabismus and their binocular sensory-motor connection is well developed. -- The common cat does not show strabismus but demonstrates an exophoria or latent divergent strabismus. Their binocular sensory connections seem rather rudimentary. Though these studies have been stated categorically they are the result of clinical examination only and not of a mathematical accuracy. The veracity of these methods is confirmed by the findings in children of three years when examined by subjective methods. However, the use of experimental methods would be useful to confirm or to deny these data.

Age Factors↗
PubMed1976

[Motor disturbances in squint - pathogenesis and treatment (author's transl)].

Motor deviation in strabismus must be considered in the context of the different elements which determine it, that is, taking account of the nature of the deviation. Modifications in the muscle may on very rare occasions be due to a paretic origin, but they can also be of innervational origin or stem from muscular modifications secondary to the innervational deviation. To decide on operative procedure, it is absolutely essential to determine the aetiology of the deviation, for normal static and dynamic motility can only be achieved by an aetiological therapy. Since muscular disorders may be of various kinds, and given that in many cases, the deviation can be cured by functional treatment alone, the author does not feel that the precise measurement of the deviation by an instrument such as the synoptometer is indispensable, the best assurance of a post-operative oculomotor balance being the suppression of abnormal accommodation and the normalisation of the retinal correspondence before the surgical intervention. This affirmation is supported by the clinical and experimental data presented in this paper.

Adaptation, Ocular↗