Investigative Ophthalmology & Visual Science Cover Image for Volume 59, Issue 9
July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
How repeatable are measures of heterophoria? Implications for clinical practice
Author Affiliations & Notes
  • Joanna Black
    School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
  • Bianca Davidson
    School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
  • Bridget Field
    School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
  • Joyce Mathan
    School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
  • Nicola S Anstice
    School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
  • Footnotes
    Commercial Relationships   Joanna Black, None; Bianca Davidson, None; Bridget Field, None; Joyce Mathan, None; Nicola Anstice, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 2957. doi:
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    • Get Citation

      Joanna Black, Bianca Davidson, Bridget Field, Joyce Mathan, Nicola S Anstice; How repeatable are measures of heterophoria? Implications for clinical practice. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2957.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Heterophoria measurement is a common clinical technique used in the diagnosis of binocular vision anomalies, the most common of which is convergence insufficiency (CI). The purpose of this study was to assess the intra- and inter-examiner variability of four clinical tests of heterophoria measurements.

Methods : Distance and near heterophorias of 20 visually-normal adults were measured using four different techniques (alternating prism cover test, von Graefe, Howell Card and Maddox Rod) on different days, by two separate examiners using standardized instructions and clinical techniques.

Results : The Howell Card had the best inter-examiner agreement at both distance (95% limits of agreement = ±1.57 prism diopters (PD)) and near (95% LOA = ±1.91 PD). Intra-examiner agreement was also best for the distance Howell Card (95% LOA = ±1.63 PD) and near (95% LOA = ±2.41 PD).

Conclusions : Howell Card is the most repeatable test both between examiners and over
time.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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