A retrospective analysis of adults with strabismus was done to examine the potential risks and the possible benefits of surgical treatment and to describe the types of adult strabismus.
Eight hundred ninety-two patients were analyzed. Age at time of surgery ranged from 9 years to 89 years. The average follow up was 34 months. Major types of strabismus were grouped by their original diagnoses. The group of patients with horizontal strabismus, which usually had an onset before 9, was termed the before visual maturity (BVM) group. The group of patients with paretic or restrictive strabismus usually had the onset of strabismus after age 9 and was termed the after visual maturity (AVM) group.
Patients with adult strabismus can gain restoration of alignment, as well as binocular function. At the last postoperative visit, 74% of the BVM group were aligned within 15 prism diopters. Not only was restoration of alignment accomplished, many of them gained some degree of sensory fusion as measured by the Worth 4-Dot (W4D) or Titmus stereoacuity. Twenty-nine percent of patients with congenital esotropia had some sensory fusion. The other subtypes in the BVM group had even higher percentages of patients with postoperative stereoacuity. In the AVM group, 92% had fusion at the last postoperative visit.
The outcomes of adult strabismics in our study show that certain benefits can be gained from correction of ocular alignment. Restoration of alignment, elimination of diplopia and sensory fusion are functional benefits that can be obtained through strabismus surgery in the adult patient. It is clear that adult strabismus is more than just a cosmetic problem and treatment is worthwhile.
In the early twentieth century a wider debate took place about how Swedish society was to fight the spread of contagious venereal diseases and in 1910 a government committee had written a law proposal that would dramatically reform these measures previously, Swedish physicians had been united against any measures against these diseases that did not involve the regulation of prostitutes, but this consensus was slowly withering away in the early parts of the century. Female doctors and a younger generation of venereologists was drawing the conclusion that mandatory checks of only one out of two sexes was insufficient. This article reviews the debate regarding the regulation of prostitution that took place between conservative and liberal members in the Swedish Medical Association in 1911. It depicts a fierce discussion between members that still clung to nineteenth-century ideas of women as being prone to prostitution if left idle and unemployed, and liberal members that believed social injustices such as low wages laid behind women's decisions. The study gives an insight into the complexities of building the Swedish welfare state.