Testing for Eye Misalignments: Ocular Motility Testing

Having regular eye exams is obviously good for testing for vision impairments including nearsightedness, farsightedness, and astigmatism. But, did you know that checking for misaligned, or crooked eyes can help detect life-threatening illnesses such as Thyroid Disease, Brain Tumors, Strokes, Diabetes, and MS?

Thanks to the development of new and more accurate testing in the world of Optometry there are many ways your Eye Doctor can detect, intervene, and treat vision disturbances long before they become problematic.

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Protecting your eye health with regular checkups and early intervention is a vital part of overall health. Your professional Calgary Optometrist at Specs in the City can provide you with thorough Ocular Motility testing, a key component of a comprehensive eye exam.

What are Ocular Motility Eye Exams?

Ocular Motility Testing is a type of eye test that can be administered to both adults and children and there are a few different ways to complete these assessments. One of the tests your Optometrist will have you complete is to check your versions; your binocular movements or the movement of both eyes in the same direction.
By having you look in six different directions, your eye doctor can assess all positions of the gaze because they each require different ocular muscles. Through this eye exam, your optometrist will assess to ensure each muscle is working to its full potential and identify any possible concerns.

The six different positions of gaze your eye doctor will assess are:

  • Left
  • Up and to the left
  • Up and to the right
  • Right
  • Down and to the right
  • Down and to the left

After this  Ocular Motility Test is complete your optometrist will look for two major indicators to see if there is a need for further testing. 

  • Did the patient have any complaints of diplopia, more commonly known as double vision?
  • Were both eyes able to move in all six directions? 

The answers to these questions will determine if further assessment is necessary.

The Cover/Uncover Test Eye Examination

The Cover/Uncover Test is an important part of your comprehensive eye exam. Simply put your optometrist will:

  • Cover one eye with a hand or paddle
  • Look for movement of the uncovered eye
  • Remove the cover of the hand/paddle
  • Observe the movement of the previously covered eye

This type of test is part of Ocular Motility Testing to determine if there is a tropia. A tropia is essentially a misalignment of the eyes and is often a sign of a serious underlying condition. As with most health conditions, early intervention through routine eye examinations is your best defence to stay healthy.

Using The Cross Cover Eye Exam to Detect Health Issues

The Cross Cover, or Alternate Cover test involves covering one eye for several seconds to suspend fusion, then covering the other eye and rapidly alternating back and forth without allowing the patient to become binocular, ensuring that one eye is always covered. During this eye examination, the covered eye is observed for any deviations or misalignments. Some of the types of misalignment that your eye doctor will watch for during this test are:

  • Exotropia: outward deviations
  • Esotropia: inwards deviations (towards the nose)
  • Hypertropia: upward deviations
  • Hypotropia: downwards deviations

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Using Regular Eye Exams For Excellent Health

Other tests to identify and measure deviations, or misalignments of the eye, include:

  • Hirshberg and Krimsky tests which use a prism
  • The three-step Bielschowsky head-tilt test
  • Worth 4 Dot test which is composed of four lights arranged in a diamond shape 
  • And the Maddox Rod test

By checking versions and performing cover tests most eye misalignments can be detected and intervened by a healthcare professional. Often further Ocular Motility Eye testing is required to determine the magnitude of any deviations, the most affected muscle(s), and whether the muscle is overacting or underacting.

If you have any concerns about your Ocular Motility, or you want to book yourself, or your children in for a routine eye examination, our team of professional Optometrists in Southeast Calgary is ready to complete a thorough and affordable eye exam.

Frequently Asked Questions: 

How do you treat eye misalignments?

Strabismus (crossed eyes) is a condition in which the eyes do not line up with one another. In other words, one eye is turned in a different direction from the other eye. Ocular Motility Tests can allow your eye doctor to determine exactly what type of deviation your eye may have and the degree of it.

How exactly to ‘fix’ a misalignment depends on the cause of it. These misalignments can be a sign of other conditions such as refractive errors, poor vision, Cerebral Palsy, a brain tumor, stroke, or neurological problems. Some of the ways to treat crooked/crossed eyes are:

  • Eyeglasses/Corrective Lenses
  • Prism Lenses
  • Orthoptics Exercises
  • Medications
  • Eye Patch
  • Surgery

Why get an Ocular Motility Eye Exam?

These simple and effective tests are performed to evaluate any weakness or underlying issues in the extraocular muscles. These problems may manifest in double vision, rapid/uncontrolled eye movements, blurred vision, headaches, fatigue, and low self-esteem, with the largest concern being even more serious underlying health concerns.

What eye muscles are tested during Ocular Motility eye exams?

The extraocular muscles are the six muscles that control the movements of the eyes:

  • The Medial Rectus moves the eye inwards
  • The Lateral Rectus moves the eye outwards
  • Superior Rectus moves the eye upwards, rotates the top of the eye towards the nose, moves the eye inward
  • The inferior Rectus moves the eye downwards, rotates the top of the eye away from the nose, and moves the eye inward
  • Superior Oblique rotates the top of the eye towards the nose, moves the eye downwards, and moves the eye outwards
  • Inferior Oblique rotates the top of the eye away from the nose, moves the eye upwards, and moves the eye outwards.
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