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PURPOSE To assess the symmetry of binocular fixation by comparing the brightness of the red reflex in each of the two eyes．This test is used to screen for strabismus, anisometropia, media opacities，and posterior pole anomalies in infants and young preverbal children．
EQUIPMENT
·Direct ophthalmoscope．
SET-UP
·The patient removes his correction．
·Room illumination should be dim．
·The examiner holds the ophthalmoscope．
·The Brückner test should be done with nondilated pils．
STEP-BY-STEP PROCEDURE
1．Direct the ophthalmoscope toward the patient’s eyes from a distance of 80 to 100 cm with the beam of light illuminating both pils．
2．Instruct patient to look at the light．
3．The examiner positions his eye directly behind the peephole of the ophthalmoscope and dials in the lens that gives a clear view of the patient’s pils．
4．Observe the Hirschberg reflexes against the red reflex in the pil(see Hirschberg procedure)．
5．Compare the brightness of the red reflexes in each of the two eyes．
a．If the two reflexes are equally bright，there is binocular fixation．
b．If the two reflexes are not equally bright，the darker red reflex indicates the fixating eye and the brighter, lighter，or whiter reflex indicates the nonfixating eye．The difference in brightness may be caused by strabismus，anisometropia，anisocoria, media opacities，or posterior pole abnormalities(see Figure 2-8)．
RECORDING
·Record which eye appears whiter and brighter
EXAMPLES
·Brückner test：0D=OS
·Brückner test：OD brighter than OS |
