History of strabismus management and treatment.

Background: Strabismus has been described since antiquity and was attributed to obscure phenomena or anatomical anomalies. The aim of this article is to examine the evolution of knowledge about strabismus and the treatments used to manage it over the centuries. This review helps us to understand how modern approaches emerged.

Methods: A bibliographical study of the history of strabismus was carried out using the Gallica platform of the Bibliothèque nationale de France (BnF). This article is based on nearly a hundred books covering a period from 1598 to 1914.

Results: During the Renaissance, knowledge about strabismus and its treatment primarily was based on texts authored by ancient medical practitioners. However, these approaches were largely ineffective due to limited understanding of the oculomotor system, for example with the face mask of Paul Aegineta. Strabismus in children was often attributed to factors like improper cradle positioning or imitation of affected individuals. Significant progress was made in the 18th century, leading to the development of the first treatment for amblyopia around 1750. This significant advance came from De Buffon, who suggested that strabismus resulted from a difference in the "strength" of the two eyes, and that covering the stronger eye would restore balance. Despite these improvements, controversies persisted about the causes of strabismus, its classifications, and the relationship with vision. By the early 19th century, detailed studies on the physiology of the eye muscles marked a turning point and paved the way for the first strabismus surgery. The procedure imagined by Dieffenbach gave initial promising results, but complications arose in many cases, such as the reappearance of strabismus or the appearance of a strabismus in the opposite direction. Later, the discovery of hyperopia and studies of binocular vision led to further advances in treatment and the development of rehabilitation methods.

Conclusion: Collectively, these advancements transformed the understanding and management of strabismus, marking crucial milestones in the history of ophthalmology.