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SURGICAL TREATMENT OF ESOTROPIA WITH BILATERAL ELEVATION IN ADDUCTION

Martin J. Urist

Abstract

IN A PREVIOUS paper,1it was shown that (1) in certain cases of horizontal squint the vertical deviations can be secondary to dissociation of the eyes; (2) examination of the eyes in the straight-up and straight-down positions of gaze is of great diagnostic importance, and (3) cases of horizontal squint with a vertical component can be classified into four main groups: Group I: esotropia with bilateral elevation in adduction; Group II: esotropia with bilateral depression in adduction; Group III: exotropia with bilateral elevation in adduction; Group IV: exotropia with bilateral depression in adduction. The essential diagnostic findings in Group I include an esotropia that is non-comitant in that the squint is greater for near and downward gaze than for distance and upward gaze. Right hypertropia is found on gaze to the left, and left hypertropia, on gaze to the right. The convergence near point is very good. The delayed

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Key concepts: Hypertropia, Esotropia, Exotropia, Medicine, Gaze, Strabismus, Ophthalmology, Psychology