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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.
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]
It is mainly used in strabismus clinics. Through this test, suppression, microtropia, diplopia and manifest deviations can be noted. However this test should always be used in conjunction with other clinical tests, such as Worth 4 dot test, Cover test, Prism cover test and Maddox rod to come to a diagnosis.
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 prism cover test (PCT) is an objective measurement and the gold standard in measuring strabismus, i.e. ocular misalignment, or a deviation of the eye. [1] It is used by ophthalmologists, orthoptists, and optometrists in order to measure the vertical and horizontal deviation and includes both manifest and latent components. [1]
Strabismus may be classified as unilateral if the one eye consistently deviates, or alternating if either of the eyes can be seen to deviate. Alternation of the strabismus may occur spontaneously, with or without subjective awareness of the alternation. Alternation may also be triggered by various tests during an eye exam.
Strabismus is a misalignment of the eyes that affects 2-4% of the population; it is often associated with amblyopia. The inward turning gaze commonly referred to as "crossed-eyes" is an example of strabismus. The term strabismus applies to other types of misalignments, including an upward, downward, or outward turning eye.
One light is held by the clinician, the other by the patient. The clinician points the light to a screen, requesting the patient to bring the second light to align on top of it. The patient's eye positions are measured while the patient performs the test. [2] Advantageously, monocular occlusion is applied before the test for at least 30 minutes.
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