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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).

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

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.

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.