Abstract
To the Editor: —Much of the current literature concerning the A-V syndromes represents an attempt to explain these complicated motor deviations in terms of the underaction or overaction of a single pair of muscles.1Dr. Tamler (Pure and Impure A-V Syndromes,Arch. Ophthal.66:524, 1961) rationalizes certain of the A-V syndromes in simple mechanical terms, but in so doing he may raise more questions than he solves. Dr. Tamler describes A-V syndromes in which vertical incomitancies are also present in the 6 cardinal positions of gaze and states that one should attempt to explain these manifestations by defects in as few muscles as possible. It is apparent that such simplified explanations may be unphysiologic, since we do not know whether the motility defect in these syndromes has to do with structure, insertion, or innervation. Scobee has illustrated the fact that when the eye looks upward from the primary position,
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