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- W2135224225 abstract "T ests of fixation preference are frequently used to diagnose and manage amblyopia in preverbal children. However, their accuracy and usefulness have become the subject of considerable controversy. They have been lauded as invaluable diagnostic aids and disparaged as inaccurate, unhelpful exercises. The usefulness of these tests really depends on the setting (clinic or community) and the examiner’s purpose. The 2 main types of fixation preference tests are binocular fixation pattern for strabismic children and the induced tropia test for children with small-angle or no strabismus. For strabismic patients, binocular fixation pattern is assessed by determining the length of time that the nonpreferred eye holds fixation. A typical grading scheme is that the nonpreferred eye will not hold fixation, holds momentarily, holds for a few seconds (or to or through a blink), or alternates spontaneously. The induced tropia test, originally described as the 10 D fixation test, is usually done by holding a 10 to 20 base-down prism over 1 eye and noting whether 1 or both eyes take up fixation. In this issue of the Journal of AAPOS, Procianoy and Procianoy report results of a study to determine the accuracy of different scales of binocular fixation preference and induced tropia tests for diagnosing amblyopia in 221 strabismic patients from 6 to 38 years old. They report a sensitivity of 73% and specificity of 78% among patients with strabismus $10, and they found a sensitivity of 90% and specificity of 64% among subjects with deviations 10. A particularly nice aspect of their study is the use of likelihood ratios to estimate the probability of amblyopia for each grade of fixation preference. Other studies have reported very good diagnostic accuracy of fixation preference tests. Sxener and colleagues found that monocular fixation pattern had good correlation with visual acuity in subjects 3 to 27 years old. Wright and colleagues reported that the induced tropia test had a sensitivity of 100% (13/13) and a specificity of 97% (64/66) in the detection of amblyopia." @default.
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- W2135224225 date "2010-06-01" @default.
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- W2135224225 title "Fixation preference tests for amblyopia: Invaluable, useless, or somewhere in the middle?" @default.
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- W2135224225 doi "https://doi.org/10.1016/j.jaapos.2010.04.004" @default.
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