[Accommodation in strabismus].

Abstract

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".