II. Indications: Strabismus Testing
- Differentiate true deviation from pseudostrabismus (due to wide Nasal Bridge or epicanthal folds)
- In uncooperative child, only test of alignment
III. Technique
- Hold penlight at arms length in front of child
- Gain child's attention blink/tap light
- When child fixated on light
- Examiner lines up light with her eyes
- Note position of Corneal Light Reflex on each eye
IV. Interpretation
- Based on Corneal Light Reflex position
- Normal (No Strabismus)
- Reflex falls on nasal portion of each Cornea
- Esodeviation
- On Deviated eye, reflex displaced lateral or temporal
- Exodeviation
- On deviated eye, reflex displaced medially
- Pseudostrabismus (due to wide Nasal Bridge or epicanthal folds)
- One pupil will appear more medial (turned in) than the other
- However, each light reflection will be centered over each pupil or in the same position as the contralateral side
V. References
- Berson (1987) Ophthalmology Study Guide, AAO, p. 95-110
- Essman (1992) Am Fam Physician 46(4):1243-52 [PubMed]
- Mills (1999) Am Fam Physician 60(3):907-16 [PubMed]
- Reedy-Cooper (2023) Am Fam Physician 108(1): 40-50 [PubMed]
- Sondhi (1988) J Pediatr Ophthalmol Strabismus 25:210-1 [PubMed]
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