[Accommodation in strabismus].

Area of Science:

• Ophthalmology and Vision Science
• Cybernetics and Systems Theory
• Neuroscience

Context:

• Clinical observations of strabismus reveal complex optico-sensori-motor symptomatology.
• Binocular visual function is conceptualized as a cybernetic 'set' with the accommodative system as a 'sub-set'.
• Existing classifications of accommodative disturbances inform the understanding of visual function rebuilding.

Purpose:

• To analyze the optico-sensori-motor symptomatology in strabismus before and during treatment.
• To compare clinical findings with theoretical models of binocular visual function.
• To propose a unified understanding of strabismus as an accommodative disturbance within a broader system.

Summary:

• Strabismus is characterized by disturbances in the accommodative mechanism, affecting the entire optico-sensori-motor system.
• "Pure" accommodative strabismus involves peripheral accommodation and is reversible with optical correction.
• "Impure" accommodative strabismus indicates a more widespread restructuring of the optico-sensori-motor set, with variable reversibility.
• Every strabismus is considered accommodative, involving a disruption of the accommodative mechanism.
• The study refutes purely "sensorial" or "motor" explanations for strabismus, emphasizing its integrated nature.

Impact:

• Challenges the dichotomy of "sensorial" versus "motor" theories in strabismus etiology.
• Highlights the interconnectedness of accommodative, sensorial, and motor systems in binocular vision.
• Advocates for integrated, multi-faceted treatment strategies for strabismus, moving beyond isolated interventions.