The Bony Orbital Walls in Horizontal Strabismus

Abstract

In the fundamental quest of etiology in nonaccommodative and nonparalytic horizontal strabismus, recent electromyographic (EMG) or electro-oculographic (EOG) studies have begun to separate—with a new index of reliability—the so-called innervational squints from those of possibly mechanical origin. Scobee's extensive works emphasized the etiologic role of structural anomalies in the check ligaments, muscle insertions, and other soft tissues of the orbit. Neither students of strabismus nor pure orbital anatomists, however, have extensively analyzed the angulations of the bony orbital walls in relation to the position of the globes. The purposes of this study are (1) to establish normal radiographic values for the angulations of the orbital walls in orthophoric persons of different sex, age, and race and (2) to analyze such bony orbital angles in relation to various horizontal imbalances. Accommodative, paralytic, and vertical heterotropias are excluded. <h3>Background</h3> The classical studies of orbital angles are those of Felix Lagrange (1903), Emil