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Photographic method for Brückner and Hirschberg testing
J R Griffin1, L N McLin, C M Schor
1Southern California College of Optometry, Fullerton.
Summary
The photographic Hirschberg test effectively detects strabismus in adults, while the Brückner test is unreliable. Further research is needed for pediatric Brückner testing.
Area of Science:
- Ophthalmology
- Optometry
- Vision Science
Background:
- Strabismus detection is crucial for timely intervention.
- Existing methods for strabismus assessment have limitations.
- Developing objective and reliable diagnostic tools is essential.
Purpose of the Study:
- To evaluate the efficacy of a novel apparatus for strabismus detection using photographic fundus and corneal reflexes.
- To compare the diagnostic accuracy of photographic Brückner and Hirschberg tests.
- To assess the influence of observer experience and anisometropia on test reliability.
Main Methods:
- An apparatus was designed to capture fundus and corneal reflexes for Brückner and Hirschberg tests.
- Photographs of adult subjects with simulated strabismus were analyzed by optometry students and faculty.
- The impact of anisometropia on Brückner test results was investigated.
Main Results:
- No significant difference in test results was observed between optometry students and faculty.
- Subject error rendered Brückner test results unreliable for adults.
- The photographic Hirschberg test accurately detected strabismus in approximately 80% of cases (magnitude ~5 delta).
- Anisometropia of 2.00 D or greater significantly impacted Brückner test outcomes.
Conclusions:
- The photographic Hirschberg test shows potential as a valuable clinical screening tool for strabismus in adults.
- The photographic Brückner test is not recommended for adult strabismus assessment.
- The reliability of the photographic Brückner test in children warrants further investigation.