Question 46 of 48

(demo test)

Product Demo for COA Exam Questions

You are evaluating a 1 year old child for strabismus.  You use your direct ophthalmoscope to obtain a red reflex simultaneously in both eyes.  The red reflex in the right eye seems duller than the red reflex in the left eye.  Which of the following statements are TRUE?  (Select only 2)

A. This is an example of the Bruckner test

B. The left eye is the deviating eye

C. This is an example of the Hirschberg method

D. The right eye is the deviating eye

E. This is an example of the Krimsky method

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Category:

Ocular Motility

High Yield:

No

Your Answers:

U

Correct Answers:

A B

Explanation:

This is an example of the Bruckner test which is one of the "light-reflex" tests used to diagnose strabismus.  This test is typically used by primary care physicians (e.g. pediatricians) to grossly screen for strabismus.  If strabismus is present, then the deviating eye will have a lighter and brighter red reflex compared to the fixating eye.  The Bruckner test is also used to screen for media opacities (e.g. cataract, vitreous hemorrhage) as well as anisometropia.

The Hirschberg method involves shining a penlight directly at the patient and observing the position of the corneal light reflexes of both eyes.  If both light reflexes are centered in the pupils of both eyes, then the patient is orthotropic.

The Krimsky method is a type of light reflex test where the examiner centers the light reflection on the deviating eye with an appropriately-powered prism.  Thus, this method can help quantify the deviation.

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