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Less may be more
For nearly a century ophthalmic surgeons have been intrigued by the possibility of surgical manipulation of the extraocular muscles to improve visual function in patients with congenital nystagmus. In 1906 Colburn described attaching the rectus muscles to the periosteum of the orbital walls in an attempt to reduce the amplitude of nystagmus.1 Widespread acceptance of this procedure did not follow. However, in 1953 Kestenbaum2 and Anderson3 described surgical approaches to correct the abnormal head position adopted by some nystagmus patients. Kestenbaum suggested surgery on all four horizontal rectus muscles (recess-resect procedures in each eye) to move the eyes away from the “null position” of the nystagmus. In contrast, Anderson proposed simply recessing the yoke rectus muscles that …
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