Thirty years ago, our attention was drawn to the alphabetical incom-
itances in strabismus. As an elevation in adduction is the most frequent
incomitance, we decided to start treating these incomitances. A weak-
ening procedure of the inferior oblique muscle seemed indicated. How-
ever, since we wanted to prevent a torsional overcorrection with a head
tilt, we displaced the scleral insertion of the oblique muscle towards
the equator of the globe. This way, the torsional action of the muscles
is saved. A weakening of the horizontal rectus muscles was
systematically added, making it a simultaneous horizontal and
cyclovertical surgery. Our way to deal with strabismus developed into a
coherent entity and the interest of colleagues encouraged us to write it
down.We decided to publish a textbook with a theoretical and an
extensive practical part. Our approach is based on thirty years of
exclusive strabological work, half-time academic and half-time private
practice. More than 6500 re- sults were analysed and the majority have
been published. The con- cerned publications are referred to at the end
of the first chapter. Private practice allowed to benefit from the fact
that patients were operated on by the same surgeon and remained in
personal contact during follow-up.