Evaluating Ocular Alignment with a Focused Light

This is a fundamental examination and is usually the first one performed by the ophthalmologist in patients with suspected concomitant strabismus. The examiner holds the light beneath and close to his or her own eyes and observes the light reflexes on the patient's corneas (Hirschberg's method) in

472 17 Ocular Motility and Strabismus Intermittent exotropia in the right eye. -

472 17 Ocular Motility and Strabismus Intermittent exotropia in the right eye. -

Fig. 17.6 a The right eye deviates in distance fixation.

b No deviation is present in near fixation.

Fig. 17.6 a The right eye deviates in distance fixation.

b No deviation is present in near fixation.

near fixation at a distance of 30 cm. Normally, these reflexes are symmetrical. Strabismus is present if the corneal reflex deviates in one eye. The corneal reflexes are symmetrical in normal binocular vision or pseudostrabismus; in esotropia, exotropia, and vertical deviation, they are asymmetrical.

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