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The test is based on the principle of diplopic projection. [1] Dissociation of the deviation is brought about by presenting a red line image to one eye and a white light to the other, while prisms are used to superimpose these and effectively measure the angle of deviation (horizontal and vertical).
The appropriate treatment for binocular diplopia depends upon the cause of the condition producing the symptoms. Efforts must first be made to identify and treat the underlying cause of the problem. Treatment options include eye exercises, [ 2 ] wearing an eye patch on alternative eyes, [ 2 ] [ 24 ] prism correction , [ 26 ] [ 24 ] [ 27 ] and ...
The test is usually performed at near. The number and type of questions asked are contingent on whether the patient has binocularity present and the consequent responses to the testing questions. The patient is firstly asked about the number of lights visible and the position and number of lines seen.
Young children with strabismus normally suppress the visual field of one eye (or part of it), whereas adults who develop strabismus normally do not suppress and therefore suffer from double vision . This also means that adults (and older children) have a higher risk of post-operative diplopia after undergoing strabismus surgery than young children.
The symptoms and signs associated with convergence insufficiency are related to prolonged, visually demanding, near-centered tasks. They may include, but are not limited to, diplopia (double vision), asthenopia (eye strain), transient blurred vision, difficulty sustaining near-visual function, abnormal fatigue, headache, and abnormal postural adaptation, among others.
The Maddox Wing test is performed at near with the instrument held in reading position, slightly inferior (approximately 15° depression and 33 cm away). The room or location of the test should be brightly illuminated and the patient's optical correction (e.g. glasses, bifocals, multifocals, contact lens) is required to be worn.
The test results are only useful in combination with other testing and results and not on their own; If performing the test twice, for example at near and at distance, the patient (especially children) may remember their previous answer and simply give the same answer from the last test, providing inaccurate results [1]
The cover test should be considered prior to testing VA patients with strabismus, for occlusion during testing may dissociate an unstable ocular deviation. In the case of intermittent or latent deviations, for dissociative complications leading to misdiagnosis, it is also advised that binocular vision is tested prior, along with stereo testing.