Ocular Motility Evaluation & Binocular Vision Assessment Flashcards

Which test best quantifies the angle of deviation in a patient who cannot fixate with either eye?

Answer: Krimsky test

The Krimsky test uses prisms over the deviating eye to center the corneal light reflex, estimating the angle when fixation is poor.

During the cover-uncover test, the covered eye moves outward when uncovered. This indicates:

Answer: Esotropia

An outward refixation movement on uncovering means the eye was deviated inward (esotropia) under the cover.

Which cyclovertical muscle is tested by asking the patient to look down and in?

Answer: Superior oblique

The superior oblique's primary depressor action is greatest when the eye is adducted, so looking down and in isolates it.

A patient with a positive Worth 4-dot test showing 5 lights at near but fusion at distance most likely has:

Answer: Intermittent exotropia with divergence excess

Intermittent exotropia with divergence excess pattern shows fusion at near (smaller deviation) but suppression/diplopia at distance (larger deviation).

The Maddox rod test dissociates the eyes by:

Answer: Converting a point light source into a streak seen only by one eye

The grooved glass converts the white dot of light into a red streak, preventing fusion and revealing the phoria.

Parks three-step test is used to identify which type of muscle palsy?

Answer: Cyclovertical muscle palsy

The three-step test (hypertropia, gaze position, and Bielschowsky head tilt) systematically isolates a single weak cyclovertical muscle.

A negative stereoacuity on the Randot test with normal Worth 4-dot fusion most likely represents:

Answer: Monofixation syndrome

Monofixation syndrome produces peripheral fusion (positive W4D) but absent or severely reduced central stereopsis.