USE OF MIOTICS IN SQUINT SURGERY* BY

AFIER operations for convergent squint, a comparatively frequent result is that the eyes are straight for distance, but on attempting near vision, the squint reappears. It happens even after a full recession of both medial recti and after the fullest possible spectacle correction. This residual acconmmodational squint proves a great handicap to the full restoration of binocular single vision and any treatment to obviate it would be welcome. The use of atropine in such cases is widespread, with the hope that paralysis of accommodation will reduce convergence. Unfortunately, atropine does not paralyse the will to accommodate. With the eyes atropinized the effort involved in attempting to obtain a clear image (frontal accommodation reflex) can cause a vicious overconvergence. We have often witnessed this unfortunate result when the child is playing with a toy or attempting to read a " get-well-quick " card. Atropine is also unsuitable in such cases because so much of the post-operative orthoptic training, especially bar reading, requires clarity of near vision