[Fixation disparity with the Pola pointing test: not representative for eye position under natural viewing conditions].
BACKGROUND
According to certain findings obtained with the Zeiss Polatest, H.J. Haase defined a "Fixation Disparity Type One". In this diagnosis, the "Zeigertest" is particularly important. The Zeigertest consists of a central ring presented to both eyes for fixation, a vertical clock hand presented to the right eye and two markings at the six and twelve o'clock positions presented to the left eye. All parts are surrounded by a binocularly visible frame. Subjects with a "Fixation Disparity Type One" see a misalignment between the clock hand and the peripheral markings. We investigated (1) whether the perceived misalignment correlated with an objective deviation of the eyes from orthovergence and (2) whether subjects with a "Fixation Disparity Type One" had a deviation of the eyes from orthovergence when looking at a natural, i.e., fully fusionable object.


METHODS
Out of 303 medical students, 10 subjects with a "Fixation Disparity Type One" were selected and asked to indicate the perceived alignment or misalignment in the Zeigertest with a laser pointer. Two subjects without fixation disparity served as controls. The position of both eyes was recorded using the search coil technique. One of the 10 subjects with "Fixation Disparity Type One" had to be excluded due to excessive blinking. Experiment 1: In the beginning all parts of the Zeigertest were presented to both eyes (natural viewing condition). Then, the object for one of the eyes was switched off leaving the frame as the only fusional stimulus. The outcome variable was a refixation movement of the other eye. This experiment is similar to the unilateral cover test. Experiment 2: In the beginning all parts of the Zeigertest were presented to both eyes (natural viewing condition). Then, the original Zeigertest was switched on (clock hand presented only to the right eye, peripheral markings only to the left eye). The outcome variable was a change of vergence.


RESULTS
Experiment 1: A significant refixation movement did not occur in any of the subjects. Experiment 2. In all 9 subjects with "Fixation Disparity Type One" the vergence changed significantly between 2.4 and 14.9 arcmin. The change of vergence correlated significantly with the angle of the perceived misalignment between clock hand and peripheral markings.


CONCLUSIONS
A fixation disparity ascertained at the Zeigertest does not indicate a fixation disparity under natural viewing conditions.
Gerling
J
J
Abteilung für Neuroophthalmologie und Schielbehandlung, Univ.-Augenklinik.
Ball
M
M
Bömer
T
T
Bach
M
M
Kommerell
G
G
D000328:Adult; D003290:Convergence, Ocular / Q000502:physiology*; D005260:Female; D005403:Fixation, Ocular / Q000502:physiology*; D006801:Humans; D008297:Male; D012016:Reference Values; D012684:Sensory Thresholds / Q000502:physiology; D013285:Strabismus / Q000175:diagnosis* / Q000503:physiopathology; D015357:Vision Disparity / Q000502:physiology*; D014787:Vision Tests; D015348:Vision, Binocular / Q000502:physiology
Fixationsdisparation am Pola-Zeigertest: nicht repräsentativ für die Augenstellung unter natürlichen Sehbedingungen.