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Inter-examiner repeatability of heterophoria tests
B B Rainey1, T L Schroeder, D A Goss
1School of Optometry, Indiana University, Bloomington, USA.
Summary
The modified Thorington method demonstrated the highest repeatability and inter-examiner correlation for measuring heterophoria (phoria). This finding is crucial for consistent clinical eye assessments.
Area of Science:
- Ophthalmology
- Optometry
- Vision Science
Background:
- Heterophoria (phoria) measurement repeatability is understudied.
- Accurate phoria measurement is essential for diagnosing and managing binocular vision disorders.
Purpose of the Study:
- To evaluate the inter-examiner repeatability of seven distinct clinical phoria measurement tests.
- To identify the most reliable method for assessing phoria in clinical practice.
Main Methods:
- Two experienced optometrists assessed 72 healthy adults using seven different phoria tests.
- Correlational and mean difference analyses were employed to assess inter-examiner repeatability.
- Tests included variations of cover tests, von Graefe phorometry, and Thorington methods.
Main Results:
- The modified Thorington method exhibited the highest inter-examiner correlation and the smallest mean difference, indicating superior repeatability.
- The prism-neutralized cover test with subjective reporting showed the second-highest correlation but the largest mean difference.
- Von Graefe phorometry methods demonstrated the lowest repeatability among the tested procedures.
Conclusions:
- The modified Thorington method is recommended as the most repeatable and reliable clinical test for heterophoria measurement.
- Clinical protocols should consider the repeatability of chosen phoria assessment techniques for diagnostic accuracy.
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