The Reversed Fixation Test
A Diagnostic Test for Dissociated Horizontal Deviation
Michael C. Brodsky, MD;
Michael H. Gräf, MD;
Guntram Kommerell, MD
Arch Ophthalmol. 2005;123:1083-1087.
Background Dissociated horizontal deviation is one of several conditions that manifest unequal horizontal deviations depending on which of the 2 eyes is fixating.
Purpose To describe the reversed fixation test as an essential tool to establish the diagnosis of dissociated horizontal deviation.
Methods Analysis of 4 case scenarios depicting the utility of the reversed fixation test.
Results The reversed fixation test distinguishes dissociated horizontal deviation from an unequal exodeviation of the 2 eyes resulting from postoperative slippage or weakness of a horizontal rectus muscle.
Conclusion The reversed fixation test is necessary to establish the diagnosis of dissociated horizontal deviation.
Author Affiliations: Departments of Ophthalmology and Pediatrics, University of Arkansas for Medical Sciences, Little Rock (Dr Brodsky); Department of Strabismology and Neuroophthalmology, University of Giessen, Giessen, Germany (Dr Gräf); and University Eye Hospital of Freiburg, Freiburg, Germany (Dr Kommerell).
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