Alternate Cover Test (Act) How Reliable Is It?

Johns, H.A.; Manny, Ruth E.; Fern, Karen D.; Hu, Ying-Sheng

doi:10.1097/00006324-200112001-00024

Cited by 4 publications

(15 citation statements)

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“…This is due to the fact that the design of the CHT is based on TH, which is known for its high reliability in measurement ( Cebrian et al, 2014 ). TH and POCT has been widely used for measuring ocular deviations ( Johns et al, 2004 ; Cebrian et al, 2014 ), and the inter-examiner COR were 1.43 △ and ± 1.65 △ for TH and POCT at distance, respectively. Our results showed the COR of CHT at distance was only 0.55 △ , which is better than TH and POCT.…”

Section: Discussionmentioning

confidence: 99%

“…A prism bar was held no further than 1 cm from the right eye while the alternate cover test was performed. The test procedure followed that described by Johns et al (2004) , and the endpoint was determined as the midpoint of the first neutral and reversal points. Subjects repeated the test three times and the mean of their results was recorded as their final heterophoria value.…”

Section: Methodsmentioning

confidence: 99%

“…Several methods have been utilized to evaluate heterophoria, including the prism-neutralized objective cover test (POCT), the modified Thorington test (TH), and the Maddox rod test (MR). POCT is often regarded as a reliable test ( Rainey et al, 1998a , b ; Johns et al, 2004 ). However, its accuracy may be influenced by the examiner’s experience, which introduces an external source of variance ( Anderson et al, 2010 ; Hrynchak et al, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

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Assessment of precision and reliability of a novel computerized heterophoria test

et al. 2023

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PurposeTo assess the precision and reliability of a novel computerized heterophoria test (CHT).MethodsOne hundred and three subjects aged 20 to 48 (27.37 ± 5.15) were recruited from Wenzhou Medical University. All subjects with corrected spectacles were examined with CHT and a prism-neutralized objective cover test (POCT) in a randomized order. They were then re-examined with CHT within 1 week. Their heterophoria was measured at three different distances (3 m, 0.77 m and 0.4 m); the average was recorded after three consecutive measurements. Inter-examiner repeatability, intra-examiner repeatability of CHT and agreement between CHT and POCT were evaluated.ResultsThere was no significant difference among repeated measurements using CHT (all p > 0.05). The difference between POCT and CHT was statistically significant at three distances (all p < 0.001). However, the mean absolute difference was 1.20△, 1.93△, and 2.41△, all of which were significantly smaller than the permissible range of error (4△) at three different distances (all p < 0.001).ConclusionThe CHT demonstrated excellent inter- and intra-examiner repeatability, as well as good correlation with POCT. The differences between CHT and POCT were within the permissible range of error, indicating that CHT could provide a precise and reliable measurement for clinical applications.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessment of precision and reliability of a novel computerized heterophoria test

et al. 2023

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“…bar to neutralize the eye deviation and quantify the severity of exophoria (Δ) 26 . The examiner added base in and base out prism until eye deviation was not observed, and the midpoint of the prism measurements was then recorded 26,31 . Participants were told to wear their usual vision correction during the test.…”

Section: Outcome Measuresmentioning

confidence: 99%

Short-Term Effect of Spinal Manipulation on the Magnitude of Exophoria in Adults Who Are Asymptomatic: A Randomized Controlled Trial

Fernández-Seguín

Peinado-Asensio²,

Díaz-Mancha

et al. 2023

Physical Therapy

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Objective This study aimed to assess the immediate and short-term effects of cervical spinal manipulation, compared with a placebo, on the magnitude of near and distance exophoria in adults with asymptomatic exophoria. Methods In this single-blind, randomized controlled trial, individuals with a clinical diagnosis of horizontal exophoria confirmed with the prism alternating cover test (PACT) were allocated to a single intervention session using a high-velocity, low-amplitude cervical spinal manipulation technique or a sham intervention (manual contact under the head). Outcomes were the magnitude of horizontal heterophoria, as a measure of binocular vision efficiency at near (40 cm) or distance (4 m) fixation, using the PACT. Evaluations were made at baseline, immediately after intervention, and at a 1-week follow-up. Results From May to September 2021, 44 volunteers (23 women), with a mean age of 35 (SD = 9.5) years, were recruited and equally distributed into the study groups. All participants completed follow-up assessments, and no adverse events were reported. There was a significant time x group interaction for exophoria at near vision, but not at distance fixation. The spinal manipulation group showed a significant decrease of near exophoria compared to the control group at the 1-week follow-up (mean difference = −1.09 prism diopters; 95% CI = −0.20 to −1.98 prism diopters). Conclusion The use of cervical spinal manipulation therapy resulted in a significant reduction of the magnitude of horizontal exophoria at near vision (medium effect size), compared with the placebo, in young adults who are asymptomatic. However, these effects were not observed at distance fixation and should be considered cautiously due to the pre-post design with a single intervention session and the short-term follow-up. Impact The findings suggest short-term benefits of spinal manipulation therapy can manage undiagnosed ocular convergence disorders, although changes were not clinically relevant.

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“…Clinical assessments designed to measure ocular misalignment often require specialist orthoptic expertise and good patient cooperation. An alternating prism cover test (APCT) is most commonly used; however, the end point of such testing can be subtle or variable and is prone to interobserver and intraobserver error, particularly in less cooperative children . Electronic instruments that use infrared light to track the eye position of both eyes simultaneously, such as video goggles and gaze trackers, have been developed to increase the precision of measurements but are mainly used for research purposes.…”

Section: Introductionmentioning

confidence: 99%

Use of a Binocular Optical Coherence Tomography System to Evaluate Strabismus in Primary Position

et al. 2018

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Alternate Cover Test (Act) How Reliable Is It?

Cited by 4 publications

References 0 publications

Assessment of precision and reliability of a novel computerized heterophoria test

Assessment of precision and reliability of a novel computerized heterophoria test

Short-Term Effect of Spinal Manipulation on the Magnitude of Exophoria in Adults Who Are Asymptomatic: A Randomized Controlled Trial

Use of a Binocular Optical Coherence Tomography System to Evaluate Strabismus in Primary Position

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