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What is hirschberg test ?
❑ It is an Ophthalmic procedure in which diagnose the degree of manifest squint.
❑ In the fields of optometry and ophthalmology, the Hirschberg test, also Hirschberg corneal reflex test, is a screening test that can be used to assess whether a person has strabismus (ocular misalignment)
Corneal light reflex testing
❑ A corneal light reflex test, also known as the Hirschberg test, is a simple exam that checks for eye alignment .
❑ The corneal light reflex is normally centered on both pupils, but if it is not centered, an eye alignment disorder may be present.
❑ It is important that the patient’s head is positioned straight and upright during the test and that both eyes are focused directly on the light.
❑ It can also be used to detect underlying conditions in children and adult if their eyes appear to be misaligned.
Hirschberg Test
❑ The Hirschberg test is a quick and easy objective method for the assessment of ocular alignment.
❑ It is also known as the corneal light reflex test as the observation is based on the judgment of the position of the corneal light reflex.
❑ This test is very handy in cases where patients are not cooperative such as children, patients who cannot fixate/track well, or when the complete ocular motility assessment is not possible.
History of hirschberg test
❑ The technique was developed by German ophthalmologist Julius Hirschberg who in 1886 used a candle to observe the light reflex in an eye with strabismus.
Procedure of hirschberg test
❑ In this procedure the patient is asked to fixate at point light held at a distance of 33 cm.
❑ Ask patient’s to head is positioned straight and upright during the test and that both eyes are focused directly on the light.
❑ The deviation of the corneal light reflex from the centre of pupil is noted in the squinting eye.
Hirschberg test Interpretation:
❑ When reflex is not center of pupil then there is squint.
❑ Reflex at Pupil Border – 15 degree
❑ Reflex into pupil border and limbus- 45 degree
❑ Reflex at Limbus – 45 degree
Hirschberg test Interpretation:
❑ Esotropia: Light reflex is shifted outwards.
❑ Exotropia: Light reflex is shifted inwards.
❑ Hypotropia: Light reflex is shifted upwards.
❑ Hypertropia: Light reflex is shifted downwards.