Exam

Visual Fixation

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Visual Fixation, Ocular Fixation

  • See Also
  1. Pediatric Eye Exam
  2. Corneal Light Reflex
  • General
  1. Child fixates on an object and follows movement
  2. Eye movement out of alignment may be normal prior to 2 to 4 months of age
  • Indication
  1. Test for Amblyopia
  2. Nonverbal or Preverbal children (reliable after 3 months of age)
    1. Infants can fixate on a face as early as 6 weeks of age
    2. Infants can fix and follow an object as early as 8 weeks of age
  • Technique
  1. Child sitting in parent's lap
  2. Interesting object presented at arms length
    1. Young Infants: examiner's face or penlight
    2. Older infants to toddlers: toys or bright colors
  3. Move object through child's fields of gaze
    1. Repeat procedure with one eye covered
  4. Avoid frightening child when covering eye
    1. Use thumb or parent's hand
  1. Child consistently cries when good eye covered
  2. Does not protest when amblyopic eye is covered
  3. Child may tilt head to compensate for Amblyopia
  • Indication
  • Referral
  1. Abnormal fixation and following by 3 months
  2. Signs of Amblyopia or strabsimus
  • References
  1. Berson (1987) Ophthalmology Study Guide, AAO, p. 106
  2. Bell (2013) Am Fam Physician 88(4): 241-8 [PubMed]
  3. Essman (1992) Am Fam Physician 46(4):1243-52 [PubMed]
  4. Mills (1999) Am Fam Physician 60(3):907-16 [PubMed]
  5. Simon (2001) Am Fam Physician 64(4):623-8 [PubMed]