[Complicated oculomotor disorders evaluated by the medical expert].

The association of sensory and motor defects may lead the medical expert to a false estimation of a patient's impairment, especially (1) if he simply adds to the sensory impairment of one eye the motor impairment of the other, without thinking of the eyes as a paired organ; (2) if he underestimates a cumulation of sensory and motor defects in the case of partial adaptation, and (3) if he judges from dyskinetic behavioral characteristics that the patient is blind. Several clinical cases illustrating these problems and allowing the following recommendations are described: (1) Prior to simply summing up the single impairments one should examine if an overlap exists. (2) In the case of cumulative disturbances with incomplete adaptation the estimated impairment should be higher. (3) To estimate an individual sensorimotor impariment that is not covered by the common recommendations, one should refer to analogous impairments, e.g. hemianopias or zones of diplopia. One should further have in mind that a patient's impairment not only depends on the objective defects, but on his personality as well. (4) Oculomotor behavioral characteristics of multiply handicapped children or of demented patients must be taken into account in order to decide whether the patient is blind or not.