Bruckner testing can be helpful in observing strabismus. When doing the Bruckner test, fundus reflex is one characteristic to pay close attention to. A patient with a strabismus may show an increased light reflex in the deviated eye. Using your occluder, occlude the non-deviated eye as if you were doing a unilateral cover test, and you may be able to observe a change in fundus reflex of the deviated eye. The reflex may change from a brighter white to a duller red. Why? The macula is usually the most heavily pigmented area of the retina; therefore, once the deviated eye takes up fixation upon unilateral occlusion, the reflex will assume a duller appearance.
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