Inter-Examiner Repeatability of Heterophoria Tests

Repeatability and Reliability of a New Phoria Test Using Flashed and Auto-flashed Presentation

“…Wong et al [1] have documented that the Howell phoria card continuous presentation and the MIM card (both continuous and flashed presentations) had significantly less validity in inter-examiner differences than the Howell phoria card flashed presentation and the von Graefe method. In results of inter-examiner repeatability of the heterophoria test from Rainey et al [10], the modified Thorington test had the highest inter-examiner correlation, and the smallest 95% limits of agreement, suggesting it was the most repeatable of the methods evaluated. The subjective cover test also had a high correlation and a small 95% limits of agreement range [10].…”

“…In results of inter-examiner repeatability of the heterophoria test from Rainey et al [10], the modified Thorington test had the highest inter-examiner correlation, and the smallest 95% limits of agreement, suggesting it was the most repeatable of the methods evaluated. The subjective cover test also had a high correlation and a small 95% limits of agreement range [10]. The repeatability of the distance Howell card test is greater than that of the distance von Graefe method and distance modified Thorington test [11].…”

“…Studies on the reliability and repeatability of measuring dissociated phoria have been conducted and methods of measuring dissociated phoria were varied and the results of reliability and repeatability were slightly different according to the researchers [1,[6][7][8][9][10][11][14][15][16][17][18][19]. The reliability and repeatability of phoria measuring methods may be affected by several factors.…”

“…The arrow pointing to an odd number on a yellow background indicated an esophoria while an even number on the blue background indicated exophoria. [10] The MIM card (Bernell Muscle Imbalance Measure card) was used for this method. The MIM card was held at 40 cm from the subjects by the examiner.…”

“…The variability, reliability and repeatability of phoria tests have been published in the magnitude of prism diopters by each method [4][5][6][7][8][9]. Variability in results of phoria tests was attributed to possible examiner bias, test technique variations, inadequate accommodative control, and subject response skill [10]. The ideal test should have good reliability and validity and should be simple to administer [11].…”