strabismus. Squinting. Lack of Muscular Balance. 453 



paralytic muscle will lag visibly behind its fellow. These con- 

 ditions are usually due to lesions in the respective nerves or their 

 cerebral ganglia. 



Spasmodic or Spastic Squint is the exact antithesis of the 

 above, the eye turning toward the muscle which is the seat of 

 spasm. It may be seen in certain cases of rabies and is always 

 due to disorder of the central nervous ganglia. 



In some cases squinting is associated with over fatigue, or de- 

 bility, and then usually partakes of the paralytic character. 



In the lower animals convergent strabismus has been most fre- 

 quently observed. Brouwer records a case in the horse and 

 Koch a congenital one in the cow. Zschokke reports a case in 

 the cow connected with an angioma at the base of the brain. 

 Other forms are noted by Peters, Barrier, Bayer and others. 

 Stockfleth quotes a case in the dog following prolapsus bulbi and 

 doubtless connected with injury to ocular muscles or nerves, 

 sustained in the accident. 



Treatment will vary with the ascertained cause. As a rule 

 cases that depend on structural changes in the brain are hopeless. 

 Those that depend on temporary congestion or other transient 

 disorder of that organ may recover when that has been overcome. 

 In cases in which debility is a prominent feature, tonics, moder- 

 ate exercise in the open air and general hygienic care "are de- 

 manded. The final resort in bad cases is tenotomy of the rectus 

 on the side toward which the eye turns. In man when this is 

 found to be insufficient the opposing weak or paretic muscle is 

 also advanced. The tendon close to its sclerotic attachment is 

 laid bare by incision, and a silk or catgut thread is passed through 

 each border, upper and lower. The tendon is now cut through 

 with scissors on the corneal side of the sutures and, by means of 

 their needles, the latter are passed through the conjunctiva and 

 capsule of Tenon, from within outward and close to the margin 

 of the cornea. The sutures are now tied somewhat tighter than 

 is absolutely necessary to properly balance the eye so as to allow 

 some room for relaxation in healing. We are not aware tlia't 

 this measure of advancement has been employed in the domestic 

 animals. 



