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Related Experiment Videos

Color dissociation artifacts in double Maddox rod cyclodeviation testing

K Simons1, K Arnoldi, M H Brown

  • 1Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, MD 21287-9009.

Ophthalmology
|December 1, 1994
PubMed
Summary

The standard double Maddox rod test may inaccurately measure cyclodeviation due to its two-color format. Using same-color Maddox rods offers a more reliable method for assessing torsion in patients with superior oblique paresis.

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Area of Science:

  • Ophthalmology
  • Neuro-ophthalmology
  • Strabismus

Background:

  • The double Maddox rod test is commonly used to measure cyclodeviation, particularly in patients with superior oblique muscle paresis.
  • Discrepancies with other torsion measures and paradoxical findings suggest the test's two-color format may introduce measurement artifacts.

Purpose of the Study:

  • To investigate potential artifacts in the traditional double Maddox rod test.
  • To evaluate an alternative same-color Maddox rod testing method for cyclodeviation measurement.

Main Methods:

  • Forty patients with superior oblique paresis underwent repeated double Maddox rod testing, with color reversal of rods.
  • Eighteen patients were further tested using same-color Maddox rods (red or clear) before both eyes.

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Main Results:

  • 83% of patients localized cyclodeviation to the eye with the red Maddox rod in the standard test, with perceived torsion laterality changing upon rod reversal.
  • 94% of patients correctly localized extorsion to the paretic eye when using same-color Maddox rods.
  • Luminance transmission and spatial frequency differences between red and clear rods likely cause the artifact.

Conclusions:

  • The traditional double Maddox rod test may yield artifactual measurements of cyclodeviation.
  • An alternative test using same-color Maddox rods is proposed for improved accuracy.
  • Testing in a dark room is recommended to mitigate visual environmental biases.