Strabismus - Fundamentals of Clinical Ophthalmology.pdf

ASSESSMENT OF STRABISMUS
Saccades
Note saccades in response to auditory or
visual targets, for example clicking fingers in
different areas of field, noting velocity, accuracy,
latency and the working together of the eyes.
Assessment of the quick phase by using an
optokinetic tape. This also gives information
about pursuit and refixation.
Smooth pursuit and range of eye
movements
Test the patient’s ability to smoothly track a
moving object, carrying out versions with both
eyes open and ductions with one eye open. The
range of eye movements is usually tested by
asking the patient to follow the target into the
nine positions of gaze.
Vergence
Testing vergence binocularity with 15 D base
out prism, vergence with accommodation,
convergence recovery, noting papillary response
along the mid-sagittal plane in the primary
position (bearing in mind light–near dissociation
of pupil responses).
Cover tests for ocular alignment
●
Cover tests measuring deviation, with
accommodation controlled with the patient
wearing the correct glasses (an accurate and
thorough assessment of ocular alignment is
●
more meaningful when the full optical
correction is worn).
Measurement of the strabismic angle using
the prism cover test (Figure 6.16).
Vestibular function
Measure acuity when shaking the patient’s
head to see if this degrades the visual acuity.
References
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