The authors investigated whether a 15-minute monocular occlusion test is as effective as the traditional 45-minute monocular occlusion test in assessing patients with divergence excess intermittent exotropia. The prospective, randomised observational study included 22 children aged 5–14 years. Children with pre-existing factors which could affect the ocular deviation measurement, or a significant neurological condition, had previous ocular surgery or botulinum toxin injections, were excluded. Researchers compared the effects on ocular deviation (alternate prism cover test), AC/A ratio, and the classification of exotropia subtypes. No statistically or clinically significant differences between the 2 testing durations was found. The prospective design and direct comparison of the 2 protocols strengthen the validity of the findings. The results suggest that a shorter 15-minute monocular occlusion test could reliably replace the 45-minute test, improving patient convenience and clinic efficiency. However, the authors report the following limitations: small sample size and measurements were performed by an unmasked examiner. The study addressed a highly applicable question to everyday practice, where reducing clinic time without compromising diagnostic accuracy is valuable. This study provides evidence for a simpler assessment protocol while maintaining diagnostic reliability.
Can a monocular occlusion test for assessing divergence excess intermittent exotropia be accurate and quicker?
Reviewed by Lauren R Hepworth
Fifteen-minute monocular occlusion test compared with 45-minute monocular occlusion test in the evaluation of divergence excess intermittent exotropia.
CONTRIBUTOR
Lauren R Hepworth
University of Liverpool; Honorary Stroke Specialist Clinical Orthoptist, Northern Care Alliance NHS Foundation Trust; St Helen’s and Knowsley NHS Foundation Trust, UK.
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