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Y.K. Hu, S.A. Newman; Efficacy of Maddox Rod Test on Evaluation of Ocular Motility Disorders . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2951.
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Purpose: To evaluate the efficacy of Maddox rod test as a screening tool for ocular motility disorders in a neuro–ophthalmology clinic at an academic institution. Methods: Retrospective chart review of all patients evaluated for the first time at a neuro–ophthalmology clinic at the University of Virginia Medical Center in a 18 month period. Maddox rod test was an essential part of the initial evaluation for most patients capable of performing the test, regardless of the patients’ subjective complain of diplopia. Hess screens were performed for selected patients as further work–up for their ocular motility problems. The findings of Maddox rod test were analyzed and compared with available Hess screen results. Results: The study included 1373 patients. 350 had subjective complain of double vision, and 1023 patients had other complaints. Out of the 350 patients with diplopia, 312 (89%) were able to perform the Maddox Rod test, 49% had exophoria, 40% had esophoria, and 62.2% had vertical deviation on the test. 7.4% of these patients were found to be orthophoric. 224 patients with diplopia had additional Hess Screen as confirmation for the Maddox Rod test, and consistency rate between the two tests was 83.4%. Among the 1023 patients without diplopia complain, 779 (76%) had undergone the Maddox Rod test. Despite of the lack of complain, only 23.6% of these patients were found to be orthophoric, while rest of them had some degree of deviations. Hess Screens were performed for 103 of above patients, and the consistency rate between the two tests was 68%. Conclusions: It has been suggested that Maddox rod is difficult for patients. In a wide variety of patients we were able to demonstrate that a vast majority were able to do the Maddox rod with reliable results. In this day of high tech analysis this simple screening tool is a rapid way of accessing ocular alignment.
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