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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]
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.
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]
The cover test should be considered prior to testing VA patients with strabismus, for occlusion during testing may dissociate an unstable ocular deviation. In the case of intermittent or latent deviations, for dissociative complications leading to misdiagnosis, it is also advised that binocular vision is tested prior, along with stereo testing.
The Maddox rod test can be used to subjectively detect and measure a latent, manifest, horizontal or vertical strabismus for near and distance. The test is based on the principle of diplopic projection. [1]
Young children with strabismus normally suppress the visual field of one eye (or part of it), whereas adults who develop strabismus normally do not suppress and therefore suffer from double vision . This also means that adults (and older children) have a higher risk of post-operative diplopia after undergoing strabismus surgery than young children.
In the fields of optometry and ophthalmology, the Lancaster red-green test is a binocular, dissociative, subjective cover test that measures strabismus in the nine diagnostic positions of gaze. The test is named after Walter Brackett Lancaster, who introduced it in 1939.
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.