The Krimsky test

The Krimsky test is a widely accepted method of assessing the angle of deviation in strabismic patients. The Krimsky test is a modified version of Hirschberg’s Test, based on the well-established principle of Hering’s law of equal innervation.

Krimsky test procedure

  • Hold the source of light such as a pen torch in front of the examiner’s dominant eye and close the non-dominant eye.
  • Shine the light from a distance of 2 feet in between the patient’s eye at the midline
  • During this test, the patient focuses on a penlight held at a distance of 30cm. A prism is then placed in front of the eye with strabismus. The direction of the base of the prism is as per relieving prism (i.e. apex towards deviation).
  • The amount of prism is gradually adjusted until the corneal reflexes are evenly positioned on both eyes.

In the Modified Krimsky Test, the patient fixates on a penlight, and prisms are added in front of the better eye (relieving prisms) until the reflection appears in the center of the deviated eye.

Krimsky test Interpretation:

The magnitude of the deviation is given by the amount of prism required to achieve centered corneal light reflex on the pupil.

Krimsky test

Click below to learn about Hirschberg test

Hirschberg test