The influence of heterophoria measurements on subsequent associated phoria measurement in a refractive routine

The influence of measuring heterophoria on a subsequent associated phoria measurement was investigated in 50 subjects. After refraction, heterophoria was measured by either von Graefe's technique or Maddox rod and wing. The effect of these procedures was assessed by associated phoria measurements taken before and after the dissociated measures. It is shown that subjects with a history of unstable binocular vision are likely to have an associate phoria induced or changed by the previous dissociated phoria measurement, particularly if von Graefe's technique is employed. It is recommended that, especially for near, associated phoria should be assessed before the dissociated phoria in subjects who are regarded as having a history of unstable binocular vision.