How do I investigate Binocular vision anomalies ?

Symptoms and history are crucial to the investigation of binocular vision anomalies, and the symptoms of decompensated heterophoria are listed. Most children with strabismus do not report symptoms, so parents should be asked whether an eye ever appears to “wander” or “turn”. Family history is also
important, especially with child patients. Parents should be asked if there is any family history of a “turning eye”, “lazy eye”, poor vision, or of refractive error (particularly long-sightedness).Afamily history of any of these will increase the risk of astrabismus being present.


One commonly asked question about orthoptic tests is “Should the patient wear a refractive correction?” For nearly all orthoptic tests, the answer is the same: the patient should wear any refractive correction that they usually wear for tasks at that distance. If there is reason for concern over binocular co-ordination and the practitioner is considering prescribing a refractive correction that is significantly different to that which is already worn, then the relevant orthoptic tests should be repeated with the new prescription in place. Most orthoptic investigative techniques will be described in the relevant sections of this book. However, one orthoptic test is
at the very core of the investigation of a great many binocular vision anomalies and will be described here: the cover test. Like most other orthoptic tests, it should be repeated at the key distances at which the patient works