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HETEROPHORIAS: I. A NEW TEST FOR VERTICAL PHORIAS, WITH OBSERVATIONS ON PATIENTS WITH PRESUMABLY NEGATIVE HISTORIES

HETEROPHORIAS: I. A NEW TEST FOR VERTICAL PHORIAS, WITH OBSERVATIONS ON PATIENTS WITH PRESUMABLY... Abstract Many new tests for heterophorias have been described by as many different authors. All of them, however, are much alike in that no new fundamental principles have been introduced. Since von Graefe1 described his diplopia test for excess of divergence, in 1857, many others have used minor variations of it. This type of test depends on the suspension of the fusion sense by creating an insurmountable diplopia in one meridian and by measuring the manifest phoria in the opposite meridian. The other type of test, of which the Maddox rod test is the best example, depends on a similar suspension of the fusion sense by producing so much distortion of one of the images that fusion is practically impossible. The manifest deviation can then be measured by prisms. In 1886, Stevens2 emphasized the importance of heterophorias and gave his widely used classification of the different types. He early References 1. von Graefe, A.: Insufficienz der inneren Augenmuskeln , Arch. f. Ophth. 3:308, 1857. 2. Stevens, G. F.: Nomenclature des differents états reunis sous le nom d'insuffisance musculaire , Arch. d'opht. 6:536, 1886. 3. Wells, D. W.: Stereoscope in Ophthalmology , Boston, E. F. Mahady Company, 1926, p. 31. 4. Peter, L. C.: Extra-Ocular Muscles , Philadelphia, Lea & Febiger, 1927, p. 20. 5. Gould, G.: Innervational Abnormalism the Cause of Heterophoria , Ann. Ophth. & Otol. 3:35, 1894. 6. Worth, C.: Squint , ed. 5, Philadelphia, P. Blakiston's Son & Company, 1921, p. 170. 7. Savage, G. C.: Ophthalmic Myology , Nashville, Tenn., Gospel Advocate Publishing Company, 1902, p. 254. 8. Zentmayer, W.: A Study of the Effect on Heterophoria of the Correction of Ametropia , J. A. M. A. 63:572 ( (Aug. 15) ) 1914. 9. Howe, L.: Muscles of the Eye , New York, G. P. Putnam's Sons, 1908, vol. 2, p. 100. 10. Stevens, G. T.: Motor Apparatus of the Eye , Philadelphia, F. A. Davis Company, 1906, p. 292. 11. Dolman, P.: Maddox Rod Screen Test , Tr. Am. Ophth. Soc. 17:235, 1919. 12. Marlow, F. W.: Prolonged Occlusion Test , Am. J. Ophth. 10:567, 1927. 13. Worth, C.: Squint , ed. 6, Philadelphia, P. Blakiston's Son & Company, 1921, p. 183. 14. Whenever prisms are referred to in this article, prism diopters (Δ) are indicated. Since 1895, most authors have been using prism diopters in their work, although not always specifically stating that they have done so. In fact, many have carelessly used the term "prism degree" for "prism diopters." 15. Savage, G. C.: Ophthalmic Myology , Nashville. Tenn., Gospel Advocate Publishing Company, 1902, p. 84. 16. Peter (footnote 4, p. 99). 17. Worth (footnote 6, p. 21). 18. Peter (footnote 4, p. 220). 19. Stevens, G. T.: Motor Apparatus of the Eyes , Philadelphia, F. A. Davis Company, 1906, p. 281. 20. Hansell and Bell: Equilibrium of the Ocular Muscles , Ann. Ophth. & Otol. 1:148, 1892. 21. Worth (footnote 6, p. 191). 22. Doak, quoted by Savage, G. C.: Ophthalmic Myology , Nashville, Tenn., Gospel Advocate Publishing Company, 1902, p. 269. 23. Manufactured by the American Optical Company, Rochester, N. Y. The instrument is now called the "Wellsworth" phorometer. 24. There is no material difference in the results if the room is fairly well lighted, but many patients have difficulty seeing only one streak under these conditions. Then, too, working in the dark results in readings less influenced by the examiner's opinions. In my experience it is rarely difficult for a patient to see both the streak and the spot with the room darkened. When difficulty is present, it seems to be due rather to an improper adjustment of the apparatus. 25. Occasionally, a horizontal prism may be needed to bring the streak and light together. 26. Marlow, F. W.: Prolonged Occlusion Test , Am. J. Ophth. 10:567, 1927. 27. Peter (footnote 4, p. 121). 28. Savage (footnote 15, p. 114). 29. The clinic is under the direction of Dr. E. V. L. Brown. 30. Walter, W.: Heterophoria and Heterotropia , Am. J. Ophth. 3:201, 1902. 31. Peter, L. C.: Extra-Ocular Muscles , Philadelphia, Lea & Febiger, 1927, p. 119. 32. Peter (footnote 4, p. 119). 33. Macklin, W. F.: Prevalence of Heterophoria , M. Clin. North America 4:337, 1920. 34. Field, P. C. : Phorometry of Normal Eyes , Arch. Ophth. 40:526, 1911. 35. Bielschowsky, A.: Ueber die relative Ruhelage der Augen , Ber. ü. d. Versamml. d. deutsch. ophth. Gesellsch. 39:67, 1913. 36. Bannister, J. M.: Hints in Relation to the Dynamics of the Extrinsic Muscles , Am. J. Ophth. 3:878, 1920. 37. Burnett, S. M.: Heterophoria and Its Relation to Asthenopia , Tr. Am. Ophth. Soc. 6:217, 1891. 38. Dolman, P.: Relation of the Sighting Eye to the Measurements of Heterophoria , Am. J. Ophth. 3:258, 1920. 39. Posey, W. C.: Study of Two Hundred and Eighty-Seven Cases of Hyperphoria , Ophth. Rev. 17:372, 1898. 40. Macklin, W. F.: Prevalence of Heterophoria , M. Clin. North America 4:337, 1920. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

HETEROPHORIAS: I. A NEW TEST FOR VERTICAL PHORIAS, WITH OBSERVATIONS ON PATIENTS WITH PRESUMABLY NEGATIVE HISTORIES

Archives of Ophthalmology , Volume 5 (5) – May 1, 1931

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References (21)

Publisher
American Medical Association
Copyright
Copyright © 1931 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1931.00820050088008
Publisher site
See Article on Publisher Site

Abstract

Abstract Many new tests for heterophorias have been described by as many different authors. All of them, however, are much alike in that no new fundamental principles have been introduced. Since von Graefe1 described his diplopia test for excess of divergence, in 1857, many others have used minor variations of it. This type of test depends on the suspension of the fusion sense by creating an insurmountable diplopia in one meridian and by measuring the manifest phoria in the opposite meridian. The other type of test, of which the Maddox rod test is the best example, depends on a similar suspension of the fusion sense by producing so much distortion of one of the images that fusion is practically impossible. The manifest deviation can then be measured by prisms. In 1886, Stevens2 emphasized the importance of heterophorias and gave his widely used classification of the different types. He early References 1. von Graefe, A.: Insufficienz der inneren Augenmuskeln , Arch. f. Ophth. 3:308, 1857. 2. Stevens, G. F.: Nomenclature des differents états reunis sous le nom d'insuffisance musculaire , Arch. d'opht. 6:536, 1886. 3. Wells, D. W.: Stereoscope in Ophthalmology , Boston, E. F. Mahady Company, 1926, p. 31. 4. Peter, L. C.: Extra-Ocular Muscles , Philadelphia, Lea & Febiger, 1927, p. 20. 5. Gould, G.: Innervational Abnormalism the Cause of Heterophoria , Ann. Ophth. & Otol. 3:35, 1894. 6. Worth, C.: Squint , ed. 5, Philadelphia, P. Blakiston's Son & Company, 1921, p. 170. 7. Savage, G. C.: Ophthalmic Myology , Nashville, Tenn., Gospel Advocate Publishing Company, 1902, p. 254. 8. Zentmayer, W.: A Study of the Effect on Heterophoria of the Correction of Ametropia , J. A. M. A. 63:572 ( (Aug. 15) ) 1914. 9. Howe, L.: Muscles of the Eye , New York, G. P. Putnam's Sons, 1908, vol. 2, p. 100. 10. Stevens, G. T.: Motor Apparatus of the Eye , Philadelphia, F. A. Davis Company, 1906, p. 292. 11. Dolman, P.: Maddox Rod Screen Test , Tr. Am. Ophth. Soc. 17:235, 1919. 12. Marlow, F. W.: Prolonged Occlusion Test , Am. J. Ophth. 10:567, 1927. 13. Worth, C.: Squint , ed. 6, Philadelphia, P. Blakiston's Son & Company, 1921, p. 183. 14. Whenever prisms are referred to in this article, prism diopters (Δ) are indicated. Since 1895, most authors have been using prism diopters in their work, although not always specifically stating that they have done so. In fact, many have carelessly used the term "prism degree" for "prism diopters." 15. Savage, G. C.: Ophthalmic Myology , Nashville. Tenn., Gospel Advocate Publishing Company, 1902, p. 84. 16. Peter (footnote 4, p. 99). 17. Worth (footnote 6, p. 21). 18. Peter (footnote 4, p. 220). 19. Stevens, G. T.: Motor Apparatus of the Eyes , Philadelphia, F. A. Davis Company, 1906, p. 281. 20. Hansell and Bell: Equilibrium of the Ocular Muscles , Ann. Ophth. & Otol. 1:148, 1892. 21. Worth (footnote 6, p. 191). 22. Doak, quoted by Savage, G. C.: Ophthalmic Myology , Nashville, Tenn., Gospel Advocate Publishing Company, 1902, p. 269. 23. Manufactured by the American Optical Company, Rochester, N. Y. The instrument is now called the "Wellsworth" phorometer. 24. There is no material difference in the results if the room is fairly well lighted, but many patients have difficulty seeing only one streak under these conditions. Then, too, working in the dark results in readings less influenced by the examiner's opinions. In my experience it is rarely difficult for a patient to see both the streak and the spot with the room darkened. When difficulty is present, it seems to be due rather to an improper adjustment of the apparatus. 25. Occasionally, a horizontal prism may be needed to bring the streak and light together. 26. Marlow, F. W.: Prolonged Occlusion Test , Am. J. Ophth. 10:567, 1927. 27. Peter (footnote 4, p. 121). 28. Savage (footnote 15, p. 114). 29. The clinic is under the direction of Dr. E. V. L. Brown. 30. Walter, W.: Heterophoria and Heterotropia , Am. J. Ophth. 3:201, 1902. 31. Peter, L. C.: Extra-Ocular Muscles , Philadelphia, Lea & Febiger, 1927, p. 119. 32. Peter (footnote 4, p. 119). 33. Macklin, W. F.: Prevalence of Heterophoria , M. Clin. North America 4:337, 1920. 34. Field, P. C. : Phorometry of Normal Eyes , Arch. Ophth. 40:526, 1911. 35. Bielschowsky, A.: Ueber die relative Ruhelage der Augen , Ber. ü. d. Versamml. d. deutsch. ophth. Gesellsch. 39:67, 1913. 36. Bannister, J. M.: Hints in Relation to the Dynamics of the Extrinsic Muscles , Am. J. Ophth. 3:878, 1920. 37. Burnett, S. M.: Heterophoria and Its Relation to Asthenopia , Tr. Am. Ophth. Soc. 6:217, 1891. 38. Dolman, P.: Relation of the Sighting Eye to the Measurements of Heterophoria , Am. J. Ophth. 3:258, 1920. 39. Posey, W. C.: Study of Two Hundred and Eighty-Seven Cases of Hyperphoria , Ophth. Rev. 17:372, 1898. 40. Macklin, W. F.: Prevalence of Heterophoria , M. Clin. North America 4:337, 1920.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: May 1, 1931

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