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Robert B. Daroff, MD
Department of Neurology University Hospitals of Cleveland Cleveland, OH 44106

Arch Neurol. 1987;44(5):473.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.

—The major points of my article¹ were the following: (1) in the office setting, the only way to be certain of a truly unequivocally positive response to a Tensilon test in a patient with suspected ocular myasthenia is to observe directly a weak muscle become stronger, and (2) to argue against the use of indirect measures such as a muscle light and prisms, red glass, Maddox rod, and Lancaster red-green torches. I loosely called these latter procedures "subjective" measures of "diplopia." Younge and Bartley correctly state that the Lancaster test is not a measure of "diplopia." Whether the test is "subjective" is open to semantic dispute.

I was distinctly aware that my discourse ran contrary to the accepted practice of many highly competent neuro-ophthalmologists. Nevertheless, for the reasons stated,¹ I remain convinced that direct observation, rather than dependence on optical devices, is the only reliable way to avoid . . . [Full Text PDF of this Article]

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