. The refraction of the eye; including a complete treatise on ophthalmometry; . sult. I suspected spasm of accommodation from the way the eyesbehaved during the test, the patient being uncertain of theglasses, and the letters fading out from time to time. Theexamination with the ophthalmoscope showed the patient to bemixed astigmatic in the right eye. Retinoscopy confirmedmixed astigmatism in the right eye, but left the diagnosis in ILLUSTRATIVE CASES 191 the left eye in doubt; in fact, indicated myopic astigmatism,which, under atropine, proved to be hypermetropic astigma-tism. I might say the
. The refraction of the eye; including a complete treatise on ophthalmometry; . sult. I suspected spasm of accommodation from the way the eyesbehaved during the test, the patient being uncertain of theglasses, and the letters fading out from time to time. Theexamination with the ophthalmoscope showed the patient to bemixed astigmatic in the right eye. Retinoscopy confirmedmixed astigmatism in the right eye, but left the diagnosis in ILLUSTRATIVE CASES 191 the left eye in doubt; in fact, indicated myopic astigmatism,which, under atropine, proved to be hypermetropic astigma-tism. I might say there were no muscle insufficiencies. Atropine solution (4 gr. to Si) was ordered to be instilled,one drop in each eye, three times a day, for four days. Thena second test was made. The ophthalmometer gave the same readings as at the firsttest. Test cards and trial R. V. = 2V0 • f* ^^- + 2 D. cyl., 90° -2D. cyl., 180°.L. ^-^: I^W. +25D. + cyl., 90°. Ophthalmoscope.— 2D. at 180° and M. D. at 90right eye ; Em. at 90° and H. D. at 180° left eye. 180. R. E. L. E. Fig. 81. Ten days later, when the effects of the atropine had left theeyes, a third test was made. The ophthalmometer read uni- 192 THE REFRACTIOX OF THE EYE formly with the two previous tests, and the subjective test,with the test cards and trial lenses, resulted in the patientaccepting the same glasses as when under the influence of atro-pine, except that the +.25 D. sphere was not accepted by theleft eye. They were accordingly ordered, a cross-cylinder+ 2 D. cyL, 90°-2 D. cyl., 180° right eye, and+ , 90° left eye. The cross-cylinders in the right eye gave abroader field and more clearly defined the letters than either ofthe sphero-cylinders into which it could be converted. How-ever, had either of the sphero-cylinders been given, it wouldhave been the minus sphere with plus cylinder, so that thecylinder would have corresponded both in character (plus) andin direction of axis (9
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