Limitations of Cover Test in Detecting Strabismus

Romano, Paul E; Noorden, Gunter K. von

doi:10.1016/0002-9394(71)91585-6

Cited by 39 publications

(25 citation statements)

References 8 publications

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“…The occlusion dissociation method in the alternate cover test gives a complete breakdown of fusional vergence and it may result in higher findings compared to other tests for heterophoria which use different dissociation methods. Moreover, we selected the measurement scale of two prism dioptres in the alternate cover test, as the minimum detectable eye movement in cover tests under ideal conditions is two prism dioptres …”

Section: Discussionmentioning

confidence: 99%

“…Moreover, we selected the measurement scale of two prism dioptres in the alternate cover test, as the minimum detectable eye movement in cover tests under ideal conditions is two prism dioptres. 17,18 Scobey and Green 19 compared five different phoria measurement techniques at near distance and suggested that these tests cannot be regarded as equivalent based on means and standard deviations alone.…”

Section: The Bland-altman Plot Comparing the Modified Thorington Tementioning

confidence: 99%

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A comparison of near‐dissociated heterophoria tests in free space

Sanker

Prabhu

Ray

2012

Clinical and Experimental Optometry

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Background:Many clinical techniques exist to quantify the magnitude of heterophoria in free space. In this article, we determine the agreement between the modified Thorington test and three different tests for dissociated heterophoria at near distance in free space. Methods:The modified Thorington, Maddox rod, von Graefe and alternate cover tests were performed on 49 university students at near distance in free space. The 95% limits of agreement between the modified Thorington and other tests were compared in pairs by using the Bland-Altman statistical test. Results: While the Maddox rod-modified Thorington pair showed narrow 95% limit range (2.5 to -3.34 Conclusion:The modified Thorington test cannot be interchanged with the other three near tests for heterophoria in free space. The accuracy in the measurement and the different methods of dissociation may play a crucial role in comparisons of the different tests for heterophoria.

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Section: Discussionmentioning

confidence: 99%

Section: The Bland-altman Plot Comparing the Modified Thorington Tementioning

confidence: 99%

A comparison of near‐dissociated heterophoria tests in free space

Sanker

Prabhu

Ray

2012

Clinical and Experimental Optometry

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“…Following standard clinical practice, the dominant eye was defined as the eye used to direct the preferred hand toward a. visual target with both eyes open. Subjects were classified as strabismic or nonstrabismic (orthotropic) using a standard clinical cover' test reported sensitive to vergence errors of 4 diopters (Romano & von Noorden, 1971). The difference in position of the images of a distant light source reflected on the two corneae confirmed the results of the cover test (Reinecke & Miller, 1966).…”

Section: Subjectsmentioning

confidence: 93%

Patterns of interocular transfer of visuomotor coordination reveal differences in the representation of visual space

Mann

Hein

Diamond

1979

Perception & Psychophysics

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Acquisition and interocular transfer of adaptation to optical transformations of input were examined in strabismic and orthotropic subjects. Distinct patterns of behavior were displayed by three groups: strabismic alternating suppressors, strabismic and orthotropic constant suppressors, and orthotropes with normal binocularity of vision. It is suggested that these behaviors result from the way in which visual space is represented in each group, an outcome of the pattern of use of the eyes during early development. The conditions for modification of the representation of visual space appear to parallel those for initial acquisition.Two principal types of monocular suppression are found among strabismic individuals: an alternating form, in which vision in each eye is suppressed part of the time, and a constant form, in which vision in one eye is consistently suppressed. We recently examined visually guided reaching in strabismic individuals and in persons with normal binocularity of vision (Mann, Hein, & Diamond, 1979). Like persons in whom the two eyes converge at the same point in visual space, alternating suppressors localized targets equivalently when using either eye, while constant suppressors did not. The discrepancies in target localization displayed by constant suppressors were attributed to their utilization of information about the posture of the dominant eye in localizing targets viewed monocularly by either eye. This implies that when targets are viewed by the normally suppressed eye, retinal locus information from that eye is combined with postural information from the dominant eye. The necessity for constant suppressors to rely upon information about the posture of the occluded eye was viewed as a result of the way in which a representation of visual space had been acquired during early development. This representation is assumed to incorporate the correspondence between direction of objects in space, retinal loci of images, and the set of postures that the eye can assume. Constant suppression of vision in one eye

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“…The authors concluded that under ideal conditions, movements of less than 2 D cannot be reliably perceived by an examiner. Romano and von Noorden (1971) also studied the smallest detectable eye movement seen on the cover test. Prisms ranging from 0.5±4 D were placed in front of the subject's right eye as an examiner watched the left eye in a mirror.…”

Section: Previous Studiesmentioning

confidence: 99%

Reliability of and comparisons among three variations of the alternating cover test

Rainey

Schroeder

Goss

et al. 1998

Ophthalmic Physiologic Optic

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One of the most commonly used methods for measuring heterophoria is the alternating cover test. Differences in specific procedures and observational criteria used by examiners may result in different measurements of heterophoria on the same patient. This study evaluated the inter-examiner reliability of three different cover test techniques: the estimated cover test, the prism neutralized objective cover test, and the prism neutralized subjective cover test. Two examiners performed each technique on each of 72 subjects. Reliability was assessed using correlational methods and mean difference calculations. Although there were some inter-examiner differences for the different techniques, all of these differences were within previously determined minimum detectable eye movement ranges. Therefore, when used by experienced clinicians, each of these techniques appears to be a reliable method of heterophoria determination, and their results are comparable.

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Limitations of Cover Test in Detecting Strabismus

Cited by 39 publications

References 8 publications

A comparison of near‐dissociated heterophoria tests in free space

A comparison of near‐dissociated heterophoria tests in free space

Patterns of interocular transfer of visuomotor coordination reveal differences in the representation of visual space

Reliability of and comparisons among three variations of the alternating cover test

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