Abnormal retinal correspondence; a preliminary report on the treatment of abnormal retinal correspondence by Cüppers' after-image method.

ABNORMAL retinal correspondence is found to be present in a considerable number of cases of concomitant strabismus. Muller (1826) thought that the anomalous projection was due to a congenital malposition of the macula of the squinting eye. It was suggested by von Graefe (1855) that the anomalous projection occurred as a result of the squint. Parinaud (1899) postulated that normal binocular function was possible in abnormal retinal correspondence, the macula of the unaffected eye being used in conjunction with a point of eccentric fixation in the squinting eye. Bielschowsky (1937) and other workers have denied that binocular vision of any useful degree could develop when one eye was fixing eccentrically. Chavasse (1939), Duke-Elder (1949), and Lyle and Walker (1950) state that abnormal retinal correspondence is prompted by a desire to develop binocular vision. Burian (1947, 1951) maintains that anomalous correspondence was acquired through usage and was an adaptation of the sensory apparatus of the eyes to their abnormal position. Various methods of treating abnormal retinal correspondence have been developed as the treatment of strabismus has improved. Travers (1940, 1950) recommended operation as being the most important single factor in the development of normal retinal correspondence, combined with orthoptic exercises. Others, including Lyle and Jackson (1940), have used kinetic stimulation at the objective angle, but with only a moderate degree of success; because of this, the method is rarely used in England now. Recently, however, Clippers (1956) has developed a new method of treatment based on the Bielschowsky after-image test. A series of 22 cases have been treated by this method at the High Holborn Branch of Moorfields Eye Hospital.