Publication: Repeatability of the Modified Thorington Card Used to Measure Far Heterophoria
Loading...
Official URL
Full text at PDC
Publication Date
2014-07
Advisors (or tutors)
Editors
Journal Title
Journal ISSN
Volume Title
Publisher
Lippincott Williams & Wilkins
Citations
Exportar
Abstract
Purpose. To determine the interexaminer and intraexaminer repeatability of the modified Thorington test (TH) for distance vision in young adults and to compare these results with those observed for the heterophoria tests most commonly used in clinical practice. Agreement among tests was also assessed.
Methods. Distance heterophoria was quantified on two separate occasions by two examiners in 110 subjects aged 18 to 32 years (mean, 19.74 years; SD, 2.5 years) using four different tests: cover test (CT) Von Graefe, Maddox rod, and modified TH. The repeatability of the tests and agreement between them was estimated by the Bland and Altman method whereby the mean difference and the 95% limits of agreement were determined as the coefficient of repeatability (COR) and coefficient of agreement.
Results. The Thorington test showed best interexaminer repeatability (COR = +/- 1.43 Delta), followed closely by CT (COR = +/- 1.65 Delta), whereas best intraexaminer repeatability was observed for CT (COR = +/- 1.28 Delta) followed by TH (COR = +/- 1.51 Delta). Among the different combinations of tests, TH and CT showed best agreement indicated by the lowest coefficient of agreement (+/- 2.23 Delta) and a low mean difference (-0.63 Delta) between measurements.
Conclusions. Good interexaminer and intraexaminer repeatability was observed for both TH and CT, and agreement between the two tests was also good. Given the simple administration of the TH, we recommend its clinical use to quantify distance horizontal heterophoria.
Description
Es la versión postprint. En la web del editor se puede encontrar el artículo "free".
UCM subjects
Unesco subjects
Keywords
Citation
1. Rainey BB, Schroeder TL, Goss DA, Grosvenor TP. Inter-examiner repeatability of heterophoria tests. Optom Vis Sci 1998; 75: 719–26.
2. Schroeder TL, Rainey BB, Goss DA, Grosvenor TP. Reliability of and comparisons among methods of measuring dissociated phoria. Optom Vis Sci 1996; 73: 389–97.
3. Wong EP, Fricke TR, Dinardo C. Interexaminer repeatability of a new, modified prentice card compared with established phoria tests. Optom Vis Sci 2002; 79: 370–5.
4. Antona B, Gonzalez E, Barrio A, Barra F, Sanchez I, Cebrian JL. Strabometry precision: intra-examiner repeatability and agreement in measuring the magnitude of the angle of latent binocular ocular deviations (heterophorias or latent strabismus). Binocul Vis Strabolog Q Simms Romano 2011; 26: 91–104.
5. Goss DA. Ocular Accommodation, Convergence and Fixation Disparity: A Manual of Clinical Analysis, 2nd ed. Boston, MA: Butterworth-Heinemann; 1995.
6. Scobee RC, Groen EL. Tests for heterophoria; reliability of tests, comparisons between tests, and effect of changing testing conditions. Trans Am Acad Ophthalmol Otolaryngol 1947; 51: 179–97.
7. Hirsch MJ, Bing LB. The effect of testing method on values obtained for phoria at 40 centimeters. Am J Optom Arch Am Acad Optom 1948; 25: 407–16.
8. Doherty BA, Geraci MJ. Comparative phoric measurements. Optom Wkly 1954; 45: 1479–81.
9. Morgan MW Jr. The reliability of clinical measurements with special reference to distance heterophoria. Am J Optom Arch Am Acad Optom 1955; 32: 167–79.
10. Morris FM. The influence of kinesthesis upon near heterophoria measurements. Am J Optom Arch Am Acad Optom 1960; 37: 327–51.
11. Lyon DW, Goss DA, Horner D, Downey JP, Rainey B. Normative data for modified Thorington phorias and prism bar vergences from the Benton-IU study. Optometry 2005; 76: 593–9.
12. Goss DA, Moyer BJ, Teske MC. A comparison of dissociated phoria test findings with von Graefe phorometry & modified Thorington testing. J Behav Optom 2008;19(6):145–9. Available at http://www.oepf.org/sites/default/files/journals/jbo-volume-19-issue-6/19-6%20Goss.pdf. Accessed May 3, 2014.
13. Casillas EC, Rosenfield M. Comparison of subjective heterophoria testing with a phoropter and trial frame. Optom Vis Sci 2006; 83: 237–41.
14. Johns HA, Manny RE, Fern K, Hu YS. The intraexaminer and interexaminer repeatability of the alternate cover test using different prism neutralization endpoints. Optom Vis Sci 2004; 81: 939–46.
15. Elliott DB. Clinical Procedures in Primary Eye Care, 2nd ed. Edinburgh, UK: Butterworth Heinemann; 2003.
16. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307–10.
17. Zadnik K, Mutti DO, Adams AJ. The repeatability of measurement of the ocular components. Invest Ophthalmol Vis Sci 1992; 33: 2325–33.
18. Fogt N, Baughman BJ, Good G. The effect of experience on the detection of small eye movements. Optom Vis Sci 2000; 77: 670–4.
19. Ludvigh E. Amount of eye movement objectively perceptible to the unaided eye. Am J Ophthalmol 1949; 32: 649.
20. Rainey BB, Goss DA, Kidwell M, Feng B. Reliability of the response AC/A ratio determined using nearpoint autorefraction and simultaneous heterophoria measurement. Clin Exp Optom 1998; 81: 185–92.
21. Weymouth FW. An experimental comparison of three common methods of measuring heterophoria. Am J Optom Arch Am Acad Optom 1963; 40: 497–503.
22. Rosenfield M. Tonic vergence and vergence adaptation. Optom Vis Sci 1997; 74: 303–28.