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Volume 50, 2000, p. 7679

Assessing the True Amount of the Deviation: Measuring Patients to Neutralization or to Reversal (Abstract)
Sara Shippman, C.O., Larisa Heiser, C.O., Lisabeth S. Hall, M.D.

Introduction and Objective:
Measurement of a deviation with the alternate cover test is a routine part of the orthoptic examination. This study was conducted to determine if there was a significant (>4PD) difference between measuring the deviation to no movement (Neutralization I) or return to no movement after reversal (Neutralization II).

Methods:
A prospective study of 33 patients at The New York Eye & Ear Infirmary Orthoptic Department.

Results:
No significant difference was seen between Neutralization I and Neutralization II in all but three patients, all of whom had esotropia of 20PD or less.

Conclusion:
Measuring to no movement (Neutralization I) seems to produce the same amount of deviation as measuring to reversal and back to neutralization (Neutralization II) in 95% of the measurements done. There is a small group of patients where the Neutralization II measurement was larger than the Neutralization I measurement by 6PD. All three patients in this group were esotropic with small angles of esotropia, 20PD or less.