Ophthalmology Book

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Cover TestAka: Cover-Uncover Exam

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  1. Indications
    1. Testing for Strabismus (exotropia or esotropia)
  2. Technique
    1. Child fixates on a point
      1. Penlight
      2. Interesting target (e.g. small toy)
    2. Cover one eye
    3. Observe movement of uncovered eye
    4. Cover other eye and repeat test
  3. Interpretation (based on movement of uncovered eye)
    1. Normal: uncovered eye maintains current position
    2. Exotropia: Eye moves inward to pick up fixation
    3. Esotropia: Eye moves outward to pick up fixation
  4. False results
    1. Causes of false positive cover test
      1. Inattention of child
    2. Causes of false negative cover test
      1. Amblyopia of uncovered eye prevents re-fixation
  5. References
    1. Berson (1987) Ophthalmology Study Guide, AAO, p. 104
    2. Essman (1992) Am Fam Physician 46(4):1243
    3. Mills (1999) Am Fam Physician 60(3):907
    4. Simon (2001) Am Fam Physician 64(4):623

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