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In the fields of optometry and ophthalmology, the Hirschberg test, also Hirschberg corneal reflex test, is a screening test that can be used to assess whether a person has strabismus (ocular misalignment). A photographic version of the Hirschberg test is used to quantify strabismus. [1]
Advantageously, monocular occlusion is applied before the test for at least 30 minutes. This largely eliminates the neurologically learned fusional vergence tone ("vergence adaptation") that is present in patients who are able to achieve fusion in a limited area of gaze, as is often the case for patients with incomitant strabismus. [3]
The test is based on the principle of diplopic projection. [1] Dissociation of the deviation is brought about by presenting a red line image to one eye and a white light to the other, while prisms are used to superimpose these and effectively measure the angle of deviation (horizontal and vertical).
The Maddox Wing test is performed at near with the instrument held in reading position, slightly inferior (approximately 15° depression and 33 cm away). The room or location of the test should be brightly illuminated and the patient's optical correction (e.g. glasses, bifocals, multifocals, contact lens) is required to be worn.
Adult and child observers perceived a right heterotropia as more disturbing than a left heterotropia, and child observers perceived an esotropia as "worse" than an exotropia. [22] Successful surgical correction of strabismus, for adult as well as children, has been shown to have a significantly positive effect on psychological well-being. [23] [24]
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Strabismus, amblyopia [11] [12] or amblyogenic disorder. Retinoblastoma [13] [2] – a neuroblastic tumor, the most common primary intraocular malignancy, and the seventh most common malignancy – 1 in 20,000 children. [14] [15] Of note other signs of retinoblastoma include strabismus, tearing red eye and iris discoloration.
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