The Impact of the Test Dissociation on the Binocular Balance of Children

Abstract

Purpose: this research compared the dissociated phoria at near and distance fixation in free space using the Howell test, alternate Cover test, and Thorington test. Methods: 220 healthy Mexican children (mean age 8.3±2.5 years) participated in this study. Phorias were quantified at both distances using each test, from the least to the most disruptive. The stereopsis degree and near point of convergence (break/recovery) were analyzed to understand their role in the visual system’s sensorimotor balance. Results: statistically significant differences were found among techniques, with a higher congruence for the EF. However, only the Howell and Thorington tests can be interchanged. The break value and near exophoria relate to each other and affect the stereopsis degree, whereas age is associated with the stereopsis degree and break value. Conclusions: the three techniques cannot be interchanged except for the Howell and Thorington test for the EF at far. The differences in the mode of dissociation could relate to the results.

Keywords

• Howell test
• alternate Cover test
• Thorington test
• dissociated phoria state
• break value of near point of convergence
• degree of stereopsis