What are the Common Eye Alignment Tests in Pediatrics?
Cover Test The cover test involves covering one eye at a time while the child focuses on an object. The healthcare provider observes the uncovered eye for any movement. If the uncovered eye moves to refocus, it suggests that the eyes were not initially aligned. This test helps identify esotropia (inward turning of the eye) or exotropia (outward turning of the eye).
Alternate Cover Test Similar to the cover test, the alternate cover test involves covering one eye and then quickly switching to the other eye while the child focuses on an object. This test helps to reveal hidden alignment issues known as phorias, where the eyes tend to drift when not actively focusing.
Hirschberg Test The Hirschberg test is a simple, quick screening tool where a light is shone into the child's eyes. The provider observes the reflection of the light on the corneas. If the reflection is not centered in both eyes, it indicates a misalignment. This test is useful for identifying large deviations.
Prism Cover Test In cases where more precise measurement of the deviation is needed, the prism cover test is employed. Prisms of varying strengths are placed in front of one eye to measure the angle of deviation. This test is often used in conjunction with the cover test to quantify the degree of misalignment.
Bruckner Test The Bruckner test involves using an ophthalmoscope to observe the red reflex in both eyes simultaneously. This test can detect asymmetries in the red reflex, which may indicate strabismus or other ocular conditions such as cataracts or retinoblastoma.
