The four-step test for diagnosis of paralytic and/or restrictive strabismus

By placing four diagnostic steps in a logical sequential manner, the diagnosis of a paralytic or restrictive deviation is made somewhat easier. Each time an incomitant strabismus is presented to an ophthalmologist, the four-step procedure should be used. Versions, ductions, and the cover test will reveal the eye to be investigated. Saccades, forced ductions, and/or forced generations will determine the problem and direct a surgical approach if needed.