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Developmental aspects of the Brückner test
1Department of Ophthalmology, Indiana University School of Medicine.
Insights
Fundus reflexes in infants change with age during the Brückner test. Asymmetric reflexes are common in infants aged 2-8 months, potentially representing normal development, unlike in older children.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Developmental Biology
Background:
- The Brückner test is used to assess visual function in infants.
- Fundus reflexes, observed during the Brückner test, can exhibit age-related variations.
- Understanding normal variations is crucial for differentiating from pathological findings.
Purpose of the Study:
- To investigate age-related changes in fundus reflex behavior during the Brückner test in normal infants.
- To establish developmental norms for fundus reflex dimming in infants from birth to 10 months.
- To determine the significance of asymmetric fundus reflexes in early infancy.
Main Methods:
- Examination of normal infants aged newborn to 10 months.
- Performance of the Brückner test to observe fundus reflexes.
- Assessment of reflex symmetry and dimming during central fixation.
Main Results:
- Infants 8 months and older typically exhibit symmetric dimming of fundus reflexes with fixation.
- Neonates and infants under 2 months often lack reflex dimming, likely due to accommodative immaturity.
- Asymmetric dimming occurs in up to 28% of infants between 2 and 8 months of age.
Conclusions:
- Fundus reflex behavior during the Brückner test shows significant age-related development in infants.
- Asymmetric fundus reflexes in infants aged 2-8 months may be a normal developmental finding.
- This contrasts with older children, where asymmetry often indicates pathology.
Abstract:
Normal infants ranging from newborn to 10 months of age were examined in order to study age-related variation in the behavior of the fundus reflexes seen in the course of performing the Brückner test. Most infants 8 months of age and older show the characteristic symmetric dimming of the fundus reflexes in both eyes occurring with central fixation. Neonates and most infants younger than 2 months of age do not show dimming of the fundus reflex with fixation, probably due to an inability to accommodate accurately. Between 2 and 8 months of age, up to 28% of infants have asymmetric dimming of the fundus reflexes in the two eyes. In contrast to older children in which this is a pathologic finding, asymmetric fundus reflexes occurring in this age range may represent a normal stage of development.