0:00Intro 0:09Heterotropia vs Heterophoria 1:45Preparation for cover tests 3:31Cover-Uncover Test -Step1 Cover test 8:13Pseudostrabismus 11:05prerequisites to avoid False negative 15:40Step2 Uncover Test 18:52Grading of fixation behaviour 21:32Incomitant Squint 23:48Alternate cover test 27:25DVD & Latent nystagmus
*Preparation for cover tests:* 1.Fixation target 2.Occluder 3. Best refractive correction 4.Head posture 5.Done in all 9 diagnostic gaze positions *False negatives of cover-uncover test:* 1.pseudosquint 2.poor vision in fixating eye less than 6/60 3.eccentric fixation (check using visuoscope or fixation star mode of direct ophthalmoscope) 4.Gross restriction of extraocular movmts
Best video ever on strabismus. so easy to follow along with ur teaching. you are a very good teacher, hats off to you!! please continue to uploaddd more
From an article on measuring deviation in a group of patients: The grading system used in this study was originally proposed by Zipf and further developed by Wright et al.3 Fixation prefer- ence was classified into 5 categories: (0) no fixation - will not hold fixation with the nonpreferred eye after the oc- cluder is removed from the preferred eye with immediate fixation to the preferred eye; (1) holds with difficulty - fixates with the nonpreferred eye momentarily but loses fixation instantly; (2) holds fixation briefly - holds 2 to 3 seconds with the nonpreferred eye when the cover is re- moved from the sound eye; (3) holds well - holds fixation almost all throughout a blink time before refixation to the dominant eye; and (4) freely alternates fixation with no preferred fixation with either eye.
in the books its given do alternate cover test after cover and uncover test , and alternate cover test is to detect total deviation - doesn't distinguish between phoria and tropia..
Excellent 👍 Dr Babita can you please do it in a different type of squint patient so it will be much clearer, and we can learn the procedure of examination as well.
On 14:25 , you say that one of the pre requisites for performing cover uncover test is "central fixation in both eyes" .. so how can we determine this before doing the cover uncover test if the eye is centrally fixating or not ? Any test for this ?
22:36 1)you said that left eye moves out to take fixation but how is it going to fixing becoz fixing done with the help of left lateral rectus but it is paralyzed in this case then how can left eye moves out ?
Thanks for your comment. You're right. In palsy (total paralysis), the eye cannot move to take fixation. The word paresis should have been used there. However, irrespective of whether it's case of palsy/paresis, one would find secondary deviation>primary deviation.
Thank you once again for yet another well detailed tutorial. But please how do we correct abnormal posture(if present) before continuing with the cover test, considering that the patient has become accustomed to the position, and will always maintain such position even unconsciously?
Thanks for your comment. We need to manually correct the head posture before performing cover test and keep it corrected till we are done with our examination.
Instead of continously adjusting it, I usually ask someone (a helper or patient's attendant) to maintain patient's head in the corrected position till I'm done with my examination.
one question---at 22;44 , if there 6th cranial palsy on the left side and the eye is already deviated nasally, when you do the cover test and occlude the right eye, which muscle pulls the left eye to midline ?
Madam, do both normal and squint eye try to fixate in alternate cover testing and we can say which eye has squint only after repeated alternate cover testing when squint becomes manifested?
In alternate squint with equal dominance, both eyes will have central, steady and maintained fixation. If one eye is dominant, the other eye will not be able to maintain fixation. Although in many cases, both eyes have equal dominance yet one eye has a greater tendency to deviate. In such cases, I personally rely on patient history and my own observation.
I appreciate your video.... I would like to add one point as per the latest literature whn we perform HBT.... 1 mm of deviation is equal to 11.8 degree.
I want to know about my eyes. I have developed this tendency in past three to four years to remove my specs and cover my left eye with hand subconsciously when using phone reading or working on laptop. I don’t even realise it for long. Usually when I am very focused in watching screen. What is my case. I wear specs around -2 both eyes having slightly different number but around -2
0:00Intro
0:09Heterotropia vs Heterophoria
1:45Preparation for cover tests
3:31Cover-Uncover Test
-Step1 Cover test
8:13Pseudostrabismus
11:05prerequisites to avoid False negative
15:40Step2 Uncover Test
18:52Grading of fixation behaviour
21:32Incomitant Squint
23:48Alternate cover test
27:25DVD & Latent nystagmus
*Preparation for cover tests:*
1.Fixation target
2.Occluder
3. Best refractive correction
4.Head posture
5.Done in all 9 diagnostic gaze positions
*False negatives of cover-uncover test:*
1.pseudosquint
2.poor vision in fixating eye less than 6/60
3.eccentric fixation (check using visuoscope or fixation star mode of direct ophthalmoscope)
4.Gross restriction of extraocular movmts
This is the most comprehensive video I’ve seen on Squint assessment! Thank you for sharing! Watching from Zambia 🇿🇲
Thanks for watching.. I'm glad you liked it! 🙏❤️
Best video ever on strabismus. so easy to follow along with ur teaching. you are a very good teacher, hats off to you!! please continue to uploaddd more
This was absolutely amazing. I don't think I have gotten such knowledge even in Prepladder subscription. Thank you!
😊
Thank you! I'm glad the content is being appreciated by its target audience.
The best video about eterotrophia on the internet. Thank you
This is an amazing and comprehensive video ever seen in my life.
Thanks for your hard work.
Brilliant, My understanding of the eye exam has improved 10 fold. Thank you
From an article on measuring deviation in a group of patients: The grading
system used in this study was originally proposed by Zipf
and further developed by Wright et al.3 Fixation prefer-
ence was classified into 5 categories: (0) no fixation - will
not hold fixation with the nonpreferred eye after the oc-
cluder is removed from the preferred eye with immediate
fixation to the preferred eye; (1) holds with difficulty -
fixates with the nonpreferred eye momentarily but loses
fixation instantly; (2) holds fixation briefly - holds 2 to 3
seconds with the nonpreferred eye when the cover is re-
moved from the sound eye; (3) holds well - holds fixation
almost all throughout a blink time before refixation to the
dominant eye; and (4) freely alternates fixation with no
preferred fixation with either eye.
A very easy way of explaining the basic of squint.excellent
What an explanation ma'am. Thank you !!
Thank you for your wonderful and clear explanation mam❤️
thank you so much Dr Babita 😍this is by far the most accurate and thoroughly explained video on squint
i would love an intermittent tropia video! thank you!
Very useful video with simple explanation.i understand very well.keep such videos in future also
So easy, elaborated and clinically helpful!
Excellent way of explaining… really worth the time. U just gained a subscriber ma’am… thanks so much..
That's impressive keep making more videos ma'am tysm I was struggling reading Parsons alot
You're welcome 😊
Pricise , comprehensive , and best explanation of squint ever . Love from pakistan ❤❤❤
Thank you for your wonderful teaching Dr.
One of the best and detailed video based on squint, thank you ma'am.
For sharing this valuable information.❤
Great explanation, easy to understand thank you mam ❤
Thanks a lot for the best possible explanation.Plz make a separate video on DVD.
i switched from prepladder to you channel, thank you mam for this much help
Glad I could help!
Easy understanding video, thanks a lots mam😊🙏
You teached really awesome and very clearly
Excellently explained
Best video on the topic ever. Thank you,🙌🙌🙏🏼
Nice examination video...
Can u make a video regarding checking ECCENTRIC FIXATION and ABNORMAL RETINAL CORRESPONDENCE.
Best video on squint! Please talk about everything contact lens.
Simply awesome thank you 😊
Amazing,y explained one of the most confusion topic well done
Most amazing clister clear video. 🎉😊
Very very wonderful lecture ma'am..I have never seen like this explanation before...thank u so much ma'am..plss make more videos on squint
Thanks for watching and supporting this channel. I will post more videos 💕
Absolutely amazing🎉
Thanks for the amazing video! Please make a video on intermittent Exotropia!
Thankew for this lecture ma'am,it really helped me understanding these topics , Stay Blessed
You're superb please upload more videos including intermittent exotropia
Perfect Video on Cover and Un-cover Test!!!
Thank you very much ! Very helpful vidéo !
Thank you so much maam
such a good class❤
Thankyouso much for this!!! Its such a useful video on earth! Thank god i stumbl3dinto this video. Gbu!!!
Thank you 😊
It was fabulous 😍
Really helpful video❤
22:40 The secondary deviation can only be assessed when the fixation behavior is grade 0, right ?
in the books its given do alternate cover test after cover and uncover test , and alternate cover test is to detect total deviation - doesn't distinguish between phoria and tropia..
Thank you so much ma'am
Ty so much. Its litl more clear now. Squint 🙄 time was long bt worth taking to clear tht concept.
Maam, ist time such a nice video on cover and uncover tesr
Thank you sooooo much❤
Best video ever!
Ti ringrazio infinitamente ❤ utilissimo e super comprensibile, se ci fosse la possibilità potresti parlare anche degli strabismi intermittenti? 😍
Very Good Explanation
great explanation👍
Brilliant video
Great video
Good... Very good..... We wants more video from Dr. Babita chanel.... On different topics
Thank youiui❤❤❤❤
Love your videos
very helpful video
Wonderful lecture yet again Dr Babita. Can you please make a video on refractive errors and also another video on intermittent squints also?
Thank you Lakshmi! I have a few videos on squint basics lined up next, for undergraduate students. Once I'm done with that, I'll cover IXT 👍
@@eyecarewithdrbabita Still waiting for your videos on intermittent squints and refractive errors! thanks!
I wholeheartedly apologize, Lakshmi!
I have been super busy lately.. Will see what I can do
19:04 or before : does Alternating squint appear as Latent squint ?
Intermittent Exotropia with poor control may present as Latent squint
Excellent 👍
Dr Babita can you please do it in a different type of squint patient so it will be much clearer, and we can learn the procedure of examination as well.
On 14:25 , you say that one of the pre requisites for performing cover uncover test is "central fixation in both eyes" .. so how can we determine this before doing the cover uncover test if the eye is centrally fixating or not ? Any test for this ?
Hi.. Fixation can be checked with the help of visuoscope/fixation star mode of direct ophthalmoscope
@@eyecarewithdrbabita can u make a video or share one regarding the fixation star mode of ophthalmoscope?
Thank you so much ❤️ very will explaining
Plzzz make video on krimsky corneal reflex test
great video thank you !
Pls how do you determine when a patient is using eccentric fixation and is also having gross restrictions of eom?
Wonderful
Thank you 😊 make more videos
Thank you, awesome!
Please make a video for removing of squint in exercise type of way
Please I need more explanation on phoria
awesome teaching
Thank you!
22:36 1)you said that left eye moves out to take fixation but how is it going to fixing becoz fixing done with the help of left lateral rectus but it is paralyzed in this case then how can left eye moves out ?
Thanks for your comment. You're right. In palsy (total paralysis), the eye cannot move to take fixation. The word paresis should have been used there. However, irrespective of whether it's case of palsy/paresis, one would find secondary deviation>primary deviation.
@@eyecarewithdrbabita not fully satisfied but ok 👍
Thank you once again for yet another well detailed tutorial. But please how do we correct abnormal posture(if present) before continuing with the cover test, considering that the patient has become accustomed to the position, and will always maintain such position even unconsciously?
Thanks for your comment. We need to manually correct the head posture before performing cover test and keep it corrected till we are done with our examination.
@@eyecarewithdrbabita Ok, thanks for that. Which means we have to continuously adjust the head position all through the test
Instead of continously adjusting it, I usually ask someone (a helper or patient's attendant) to maintain patient's head in the corrected position till I'm done with my examination.
@@eyecarewithdrbabita Ok, that sounds better
please do us a video of 21 steps
Great !
Why do we need fixation target for near and distant ?
Super mam .....explanation
one question---at 22;44 , if there 6th cranial palsy on the left side and the eye is already deviated nasally, when you do the cover test and occlude the right eye, which muscle pulls the left eye to midline ?
Thank you mam
Hi can this be done without translucent occluder?
Just wow.
Kindly do a video on intermittent oesotropia
Osm lecture mam
nice presentation madam
thank you very much! great valuable explanation , ma be a new video about Altenate Exotopia especially in Childern 🙏
Is se behar video mne aj tak nai dekhi
I LIKE THIS VIDEO , AWESOME ! I HOPE GOT MORE VIDEO FOR THIS ~~~
Please one video of Acc and non Acc Esotropia
Awesome 👍👍 u r ophthalmgst or optometrst
Madam, do both normal and squint eye try to fixate in alternate cover testing and we can say which eye has squint only after repeated alternate cover testing when squint becomes manifested?
In alternate squint with equal dominance, both eyes will have central, steady and maintained fixation. If one eye is dominant, the other eye will not be able to maintain fixation. Although in many cases, both eyes have equal dominance yet one eye has a greater tendency to deviate. In such cases, I personally rely on patient history and my own observation.
How to exclude eccentric fixation?
I appreciate your video.... I would like to add one point as per the latest literature whn we perform HBT.... 1 mm of deviation is equal to 11.8 degree.
Thank you for your input!
Mam how to treat Alternate exotropia about 15 degree kindly suggest best way of treatment.
Want video on Intermittent Exotropia
GREAT
I want to know about my eyes.
I have developed this tendency in past three to four years to remove my specs and cover my left eye with hand subconsciously when using phone reading or working on laptop. I don’t even realise it for long. Usually when I am very focused in watching screen.
What is my case.
I wear specs around -2 both eyes having slightly different number but around -2
Maam how to check whether eye having eccentric fixation or Abnormal retinal correspondence ARC through worth 4 . Test? And for palsy and contracture?