Binocular Alignment
Binocular alignment is evaluated with a cover test. The examiner holds a point light source beneath his or her own
eyes and observes the light reflec-tions
in the patient’s corneas in the near field (40 cm) and at a distance (5
m).The reflections are normally in the center of each pupil. If the
corneal reflection is not in the center of the pupil in one eye, then a tropia
is present in that eye. Then the examiner covers one eye with a hand or an
occluder (Fig. 1.6) and tests whether the uncovered
eye makes a compensatory movement. Compen-satory movement of the eye
indicates the presence of tropia. However, there will also be a lack of
compensatory movement if the eye is blind. The cover test is then repeated with
the other eye.
If tropia is present in a newborn with
extremely poor vision, the baby will not tolerate the good eye being covered.
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