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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.
A cover test can tell you the extent of the eso/exo-tropia. Individuals can suffer from several tropias at once. In Graves ophthalmopathy , it is not uncommon to see an esotropia (due to pathology of the medial rectus muscle ) co-morbid with a hypotropia (due to pathology of the inferior rectus muscle ).
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]
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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).
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.
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.
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.