(1) In functional squints, it is necessary to assess, in each case, the exact and particular role played by innervational and viscoelastic impairments by carrying out a thorough clinical examination, an electro-oculographic recording and the anesthetic and muscle elongation tests. Such an appraisal is still only approximate, however. (2) Various surgical methods permit the suppression of the deviation but all the procedures are purely empirical, and their results have no pathogenetic significance. Moreover, all the surgical actions cause some muscle and sheath scarring. For all these reasons, a high rate of succes of one-step surgery is not possible. (3) An accurate appraisal of motor balance and, in particular, of the sensory state is very difficult. It can only be achieved by successive controls over a long period of time. Early surgery has many substantial drawbacks. The adjustable-suture technique is very tempting, but the lack of cooperation of most young children renders its use difficult.

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