This is the Maddox rod test. This test is used to uncover latent squints (phorias). A phoria is a latent deviation. This means that the deviation is not apparent unless fusion is broken. For the phoric patient, the natural resting position of the eye muscle system is not ortho (straight). When the patient is visually active (i.e. awake and alert) the power of fusion keeps the eyes straight. If fusion is broken by dissimilar visual targets, (e.g. the Maddox Rod test), then the eyes move to their natural resting positions.
The Maddox rod is a disc of red glass in which are molded grooves. When a distant spot of light is viewed with the disc in front of one eye, a red line will be seen by the eye covered with the lens, whilst a spot of light will be seen with the other eye. The line will be at right angles to the grooves to that when these are horizontal the line will appear vertical. A candidate with no latent deviation will see the coloured line pass through the spot of light (orthophoria), whereas a candidate with latent squint will see the light source to one side of the line.
The Maddox rod with rotating prism is held in front of the right eye and the candidate is asked to look at a point source of light 6m (20 ft.) away in a darkened room. Both eyes must be open and squinting should be avoided. The candidate is asked which side of the line the dot is seen. If it is to his right, esophoria is present and if to the left, exophoria. The candidate is then asked to “put the line on the light” by adjusting the rotating prism. The examiner reads off the degree of phoria from the scale on the device.
The test is repeated with the disc turned to the vertical position. The light will now be seen either above or below the line and may be adjusted by the candidate in the same way. If the red line is above the light there is left hyperphoria, if below the light, right hyperphoria.
We only do the test for phorias on Class 1 and 2 exams. It is not required for Class 3.