The enigmatic strabismus of Albrecht Dürer.

The author discusses several of Albrecht Dürer's selfportraits. In some portraits his eyes are straight and in some others a divergent squint is present. Did Dürer do this on purpose or whas the squint indeed intermittently present? Analysis of the portrait of his mother gave the explanation.

Lights and darks of a picture. The life of Giovanni Francesco Barbieri, "il Guercino" - the squinter.

PURPOSE: To be cross-eyed is a wide-spread dysfunction of the eye and squinting is currently regarded as unattractive. However, in ancient times, societies saw squinting as a sign of piety or even beauty. Even Venus was depicted heterophoric quite often. The most famous artist who was cross-eyed was Giovanni Francesco Barbieri (*08.02.1591; †22.12.1666, both Italy). His nickname was "Il Guercino" which means "the squinter." This article reflects on vision and art from the perspective of a cross-eyed person. METHODS: Life and work of Giovanni Francesco Barbieri was analyzed and interpreted based on selective literature research of books and journal articles via PubMed, Google Scholar, and Google. RESULTS: As squinters use mostly only one eye as the other eye is amblyopic, it could be expected that their paintings would be more or less two dimensional. Already at the age of seven, Barbieri showed great talent in drawing and painting. At age 17, he started his education at the famous Bologna school. Barbieri was very productive, leaving behind, at his death,106 large altarpieces and 144 other paintings. During his lifetime, he was well accepted, sought after, and quite wealthy. In analyzing a selection of Barbieri's work, one is amazed at how detailed the artist was in depicting chiaroscuro in his paintings to present a three-dimensional picture. CONCLUSIONS: Barbieri did not make a secret of the dysfunction of his eyes. In contrast, he showed his squinting eye distinctly in his famous self-portrait from ca. 1635. It can be assumed that "Il Guercino" was so detailed in studying light and shadow with his one eye that he could compensate for his amblyopic eye. By this, Barbieri could create pictures with an amazing degree of variations of light and shadow.

Strabismus in Bronzino's paintings: a hallmark of a realistic painter?

The present article analyses eleven paintings of Bronzino, one of the major painters of the late Italian Mannerism, in which the sitters are portrayed with deviating eyes. The reasons why Bronzino may have included a truant eye in his subjects are herein discussed. We consider the 'wandering' eye as a hallmark of Bronzino's style. The inclusion of strabismus may be part of the Mannerism tendency of using exaggerated hallmarks but pursuing at the same time an increasing realism that was typical of the 15th and 16th century movements.

What Did They Know Then? A Journey Among the Giants of the Past.

Dr. Richard Scobee has the honorary title "The Father of American Orthoptics." In addition to his numerous accomplishments in his academic career, he had hobbies that included collecting historical stamps. In tribute to his love of things past, this lecture will delve into the remote history of ophthalmology, to see what eminent pioneers knew and wrote about eye muscle disorders and binocular vision in their treatises. Our journey will include eight personalities and their works, ranging from the 7th century through to the early 19th century, and will encompass Europe, the Middle East, Great Britain, and North America. Analyzing the writings of these masters affords glimpses into the knowledge base and philosophies that were prevalent in different centuries. Many of these individuals were innovators who pushed the boundaries of knowledge. Some of them made advances using intuition and reason, mainly through case experience and case studies, while others used the scientific method to gain new information. In many cases, the words written by these luminaries centuries ago still resonate with us today and guide us in our everyday practices. It is hoped that this journey will be enlightening for orthoptists, ophthalmologists, and allied health personnel, and confirm, as in many areas of science, that we truly stand on the shoulders of giants, the masters from the recent and the distant past.

Michael Constantine Psellus (1020-1105 AD) and his definition of strabismus.

Strabismus was a known eye misalignment since the Hippocratic era (ca 5th century BC). Hippocrates and his followers were the first to introduce the hypothesis of a hereditary condition. Many ancient Greek physicians like Galen (ca 2nd AD) provided several definitions, while Paul of Aegina (625-690 AD) was the scholar who introduced a method to treat it. Paul used a full face mask and an oil lamb to guide the eyeballs toward the desired direction. It seems that this approach endured for centuries to come. During 11th century AD in Constantinople, the Byzantine scholar and politician Michael Constantine Psellus (ca 1020-1105 AD) composed a series of philosophical, religious, political and scientific treatises. Among his work stands a medical iambic didactic poem of 1732 lines, in which he had mentioned strabismus. Although he was not an oculist, he had managed to define strabismus. His definition was noted as such, "Strabismus is caused by a spasm of the bodies which move (the eye balls) and the oblique tendency of the muscles". Psellus was aware of the knowledge of the past and recorded what was still valid at that era, presenting a memorable definition. As his reference was completely neglected from the medical bibliography, our study aims to add him in the scientific chain of those who understood this disorder. This study aims to compose Psellus biography, present ancient Greek and Byzantine ophthalmology's opinion concerning strabismus and note Psellus' definition. The TLG and MedLine/PubMed databases were searched and the terms "strabismus" and "Psellus" were used as key words.

Why did Donders, after describing pseudotorsion, deny the existence of ocular counterrolling together with Ruete, Volkmann, von Graefe and von Helmholtz, until Javal reconfirmed its existence?

After the rapid spread of strabismus surgery by total tenotomy, which had been proposed by the orthopedist Louis Stromeyer from Göttingen in 1838 and performed by the plastic surgeon Johann Friedrich Dieffenbach on October 26th and by the ophthalmologist Florent Cunier on October 29th, 1839, brilliant researchers studied the physiology of eye movements, resulting in the laws by Franciscus Cornelis Donders on pseudotorsion in tertiary positions of gaze and by Johann Benedict Listing that each eye position can be reached by rotation about an axis perpendicular to the primary and the new position of gaze. John Hunter had first described ocular counterrolling (OCR) with head tilt in 1786. The anatomist Alexander Friedrich von Hueck inferred from anatomical studies, however, that up to 28.6° OCR would be possible onhead-tilt to right or left shoulder in 1838, and estimated his own OCR seen in a mirror at approximately 25°. Donders, Christian Georg Theodor Ruete, Alfred Wilhelm Volkmann, Albrecht von Graefe and Hermann von Helmholtz subsequently denied the existence of OCR for many years and thought that only pseudotorsion existed. Louis Emile Javal had myopia and astigmatism, and he re-established the existence of OCR in 1867 when he noticed that, on head tilt to either shoulder, the axis of astigmatism of his eyes no longer coincided with the axis of astigmatism of his glasses.

La enfermedad ocular de Jean-Paul Sartre y su repercusión en su obra literaria / The eye disease of Jean-Paul Sartre and its impact on his literary work

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Paul of Aegina (c. 625-690 AD), the Origins of the Early Correction of Pediatric Strabismus in Byzantine Empire.

The eminent Greek physician Paul of Aegina, native of the Saronic island Aegina and pupil of the Alexandrian School, understood both exotropia and endotropia, his designation for esotropia and proposed therapeutic measures for their treatment during baby or toddler age. He had introduced an innovative method for the newborns to have a straight vision, "the congenital strabismus of the newborns must be treated with the placement of a facial mask (with 2 open holes in the middle axes of the eyes), so that the babies could only see in a straight line", combined with a small oil lamp to assure a direct eye alignment. Although not even a diagram of the masks was saved until nowadays, Paul was the first to suggest the early correction of the eyes deviation, and considered to be the father of orthoptics.

Early American Strabismus Surgery: 1840-1845.

The discovery of effective surgical therapy for strabismus was one of the outstanding triumphs of the first half of 19th-century ophthalmology, just prior to the invention of the ophthalmoscope in 1850. Although priority for the development of strabismus surgery belongs to Johann Friedrich Dieffenbach of Germany, who first reported his surgical results in 1839, 4 cases of tenotomy of the medial rectus muscle had been performed in the United States by William Gibson in 1818 but never published. By 1840, the reports of surgery in Europe had rapidly spread to America where surgeons immediately began using these procedures. The first American surgeon to perform eye muscle surgery and publish his results was John Dix of Boston, and other surgeons were soon reporting their cases as well. We discuss 8 American pioneers in this field during the time (1840-1845) of the first burst of enthusiasm for this surgery. Although these surgeons were active in performing a large number of cases and carefully reporting their experiences and results, they did not make any major advances in the field.

A History of Orthoptics in the United States, Part I: "If You Build It, They Will Come".

The year 2015 marks the 75th anniversary of the American Association of Certified Orthoptists (AACO), the second oldest orthoptic professional organization in the world. Since its inception, October 7, 1940, approximately 90% of all certified orthoptists (C.O.) have consistently maintained membership in their professional society. Approximately 80% of AACO members attend AACO-sponsored scientific meetings at least once annually. And 17-20% of members are actively involved in AACO leadership, management, and activities.Eye care has changed dramatically over the last 75 years, and orthoptics has successfully adapted to survive due to the fortitude and resilience of its practitioners. The AACO has weathered opposition from much more powerful competitors, ever-increasing health care regulation, and an evolution in the standard management of strabismus, only to emerge transformed and even more durable. One constant remains: the qualities that inspired thirty-three individuals to create a profession and a society dedicated to the care of patients with strabismus and disorders of binocular vision, and the education of parents, orthoptists, and ophthalmologists exist in every orthoptist today. These qualities are determination, creativity, dedication, and passion.

Was Rembrandt strabismic?

PURPOSE: We studied a set of Rembrandt's self-portraits to reassess a previous claim, based on measurements of the centration of his painted irises, that Rembrandt had a large exotropia. METHODS: Of the 24 self-portraits that Rembrandt painted, with significant ocular detail to give an impression of the direction of his gaze, we scanned 10; the five with the largest difference in centration between the irises and the five with the smallest difference. The right and left eyes in each image were then occluded using Photoshop to produce two additional images that gave monocular gaze. Thirty observers then judged where the portraits appeared to be gazing within the plane of their face. RESULTS: Although our observers did judge a significant outward deviation for gaze between the two eyes, part of this was caused by an outward deviation from central by the presumably nonstrabismic eye. Any greater amount of outward deviation from the "strabismic" than the nonstrabismic eye can then be explained by a gaze overshoot induced by head turn, painting with a mirror, and angle kappas. In addition, Rembrandt's apparent strabismus is seen only in those portraits painted during a few years early in his career, and portraits that Rembrandt and his students produced of other presumably nonstrabismic individuals often give a similar impression of strabismus. CONCLUSIONS: There are several factors that can explain why some of Rembrandt's self-portraits make him look strabismic without concluding that he actually was. Rembrandt and his students may also have painted this appearance as an artistic style.

Historia de la oculística con especial dedicación a la estrabología / No disponible

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