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...