developed, the preferred option is a simple recession, or weakening, of the medial rectus of the affected eye, combined with a resection, or strengthening, of the lateral rectus of the same eye. however, where the inhibitional palsy of the contralateral lateral rectus has not developed, there will still be gross incomitance, with the disparity between the eye positions being markedly greater in the field of action of the affected muscle. in such cases recession of the medial rectus of the affected eye is accompanied by recession and/or posterior fixation (fadenoperation) of the contraleral medial rectus. the same approaches are adopted bilaterally where both eyes have been affected.