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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 and orthoptists in order to measure the vertical and horizontal deviation and includes both manifest and latent components. [ 1 ]
A fixation disparity is not constant within a certain observer, but can vary depending on the viewing conditions. If test prisms with increasing amount are placed in front of the observer’s eyes, the fixation disparity changes in the eso direction with base-in prisms and in the exo direction with base-out prisms (Fig. 3).
The strength of the prism is increased until the streak of the light passes through the centre of the prism, as the strength of the prism indicates the amount of deviation present. The Maddox rod is a handheld instrument composed of red parallel plano convex cylinder lens , which refracts light rays so that a point source of light is seen as a ...
The unilateral cover test is performed by having the patient focus on an object then covering the fixating eye and observing the movement of the other eye. If the eye was exotropic , covering the fixating eye will cause an inwards movement; and if esotropic , covering the fixating eye will cause an outwards movement.
The prism fusion range (PFR) or fusional vergence amplitude is a clinical eye test performed by orthoptists, optometrists, and ophthalmologists to assess motor fusion, specifically the extent to which a patient can maintain binocular single vision in the presence of increasing vergence demands.
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 test called the Bielschowsky Darkening Wedge Test can be used to reveal and diagnose the presence of dissociated vertical deviation, although any (or no) amount of dissociative occlusion may also prompt it to occur. The patient is asked to look at a light. One eye is covered and a filter is placed in front of the other eye.
This test is performed on patients suspected to have small angle deviations of less than 10 prism dioptres, a microtropia, that may or may not have been observed on cover test because of subtle eye movements. The test determines whether the patient has bifoveal fixation or monofixation despite their eyes seeming straight. [2]