II. General
- Child fixates on an object and follows movement
- Eye movement out of alignment may be normal prior to 2 to 4 months of age
III. Indication
- Test for Amblyopia
- Nonverbal or Preverbal children (reliable after 3 months of age)
- Infants can fixate on a face as early as 6 weeks of age
- Infants can fix and follow an object as early as 8 weeks of age
IV. Technique
- Child sitting in parent's lap
- Interesting object presented at arms length
- Young Infants: examiner's face or penlight
- Older infants to toddlers: toys or bright colors
- Move object through child's fields of gaze
- Repeat procedure with one eye covered
- Avoid frightening child when covering eye
- Use thumb or parent's hand
V. Interpretation: Amblyopia present
- Child consistently cries when good eye covered
- Does not protest when amblyopic eye is covered
- Child may tilt head to compensate for Amblyopia
VI. Indication: Referral
- Abnormal fixation and following by 3 months
- Signs of Amblyopia or strabsimus
VII. References
- Berson (1987) Ophthalmology Study Guide, AAO, p. 106
- Bell (2013) Am Fam Physician 88(4): 241-8 [PubMed]
- Essman (1992) Am Fam Physician 46(4):1243-52 [PubMed]
- Mills (1999) Am Fam Physician 60(3):907-16 [PubMed]
- Simon (2001) Am Fam Physician 64(4):623-8 [PubMed]