[Symptomatologic value of dissociated vertical divergence in concomitant strabismus]. / Valeur séméiologique de la divergence verticale dissociée (D.V.D.) dans le strabisme concomitant.

D.V.D. is an opto-motor anomaly which is likely starting from the retina. D.V.D. is seldom isolated and it is most often found in congenital strabismus or in early onset strabismus (with or without alterared fusion) with an horizontal deviation most often associated with a vertical syndrome. The clinical assessment of D.V.D. is of major importance in the pre and post-operative examination. The simultaneous horizontal and vertical surgery reduces the amplitude of D.V.D by re-establishing a central or peripherical fusion.

[Simultaneous surgical procedures on the horizontal and vertical muscles in the treatment of convergent strabismus]. / Jednoczesna interwencja chirurgiczna na miesniach poziomych i pionowych w leczeniu zezów zbieznych.

In convergent squints the vertical component is very often accompanying the horizontal deviations. This phenomenon is mostly accentuated in congenital squints and in squints very early aquired (onset of squint before the 1st year of life). If after the operation the binocular vision has to be secured indispensable is a surgical procedure which liquidates simultaneously the horizontal as well as the vertical deviation. The operation should be minimally traumatizing; the use of the microscope is most advisable. Preoperative, minute analysis of the motility of the eyes may be performed not earlier than after the child is 2.5 years old. The over mentioned conclusions have been drawn on the basis of analysis of 460 operated cases observed 1 to 5 years.

[Simultaneous horizontal and vertical surgery in esotropia]. / La chirurgie horizontale et verticale simultanée dans les ésotropies.

The vertical syndrome depends on the triple action of the vertical muscles and includes vertical, alphabetical and torsional patterns; this syndrome is of major importance in the diagnosis and treatment of esotropia. We advise routine simultaneous surgery of the horizontal and vertical components. In congenital and early esotropias which occur before one year of age, extensive tests of sensorial evaluation cannot be carried out before three years of age and the vertical syndrome should therefore upon automatically be operated whatever its severity. The advantage of this type of surgery is unquestionable for removal of obstacles preventing recovery of a form of binocular vision. In acquired esotropias when good sensorial conditions (fusion, N.R.C., stereopsis) may be elicited after three years of age and when there is a minor vertical syndrome, vertical surgery might be considered as optional, but as vertical surgery is not dangerous, it can only be regarded as beneficial. With our surgical technique we obtain successful long-term results for horizontal deviation, which improves progressively (83%); vertical and alphabetical patterns improve in similar proportions (65 and 64% respectively). Surgical results depend on which of the following two forms of esotropia is present: in congenital and early esotropias a form of binocular vision with an angle of anomaly occurs almost without exception; in acquired esotropias a form of binocular vision without an angle of anomaly sometimes occurs. Overcorrections require second stage operation, which are simple and nonmutilating when the removal of convex glasses or the use of concave glasses does not reduce secondary exodeviation. Successful results of post-operative fusion confirm the beneficial influence of surgery on the vertical syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

Treatment of heterophorias.

It is well known that the treatment of heterophorias is first of all medical (optical and orthoptic). In some cases surgery is required. The surgical indications are stressed by the authors.