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Parks–Bielschowsky three-step test

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See also: Bielschowsky's head tilt test

The Parks-Bielschowsky three-step test,[1] also known as Park's three-step test, Bielschowsky head tilt test,[2] is a method used to isolate the paretic extraocular muscle, particularly superior oblique muscle and trochlear nerve (IVth cranial nerve),[3] in acquired vertical diplopia.[4] It was originally described by Marshall M. Parks.[5]

History

The physiologic basis of the head tilt test was explained by Alfred Bielschowsky and Hofmann[6] in 1935. However, Nagel described it 30 years prior to Bielschowsky when he noted that the combined action of the superior rectus muscle and the superior oblique muscle of one eye and of the inferior rectus and inferior oblique muscles in the fellow eye causes incycloduction and excycloduction. The procedure that we now follow was given by Marshall M. Parks.[7]

References

  1. ^ Yeung, Pauline HN (10 September 1998). "Fourth nerve palsy with monovision". Clinical and Experimental Optometry. 81 (5): 206–209. doi:10.1111/j.1444-0938.1998.tb06737.x. PMID 12482321. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  2. ^ Elliott, David B. "6.16: Identifying the Defective Muscle: Parks 3-Step Test". Clinical Procedures in Primary Eye Care (4th ed.). Retrieved 2 February 2014. citing von Noorden GK: Binocular vision and ocular motility: Theory and management of strabismus. London, CV Mosby, 2002.
  3. ^ Yanoff, Myron; Duker, Jay S. (13 December 2013). Ophthalmology: Expert Consult: Online and Print. Elsevier Health Sciences. p. 1220. ISBN 978-1-4557-3984-4.
  4. ^ Wang, Frederick M. "Strabismus" (PDF) (Document). p. 6. Retrieved 2 February 2014. {{cite document}}: Cite document requires |publisher= (help); Unknown parameter |accessdate= ignored (help); Unknown parameter |url= ignored (help)
  5. ^ Helveston, Eugene M. (ed.). "Diagnosis and Classification of Superior Oblique Palsy". Project ORBIS International Inc. Retrieved 2 February 2014.
  6. ^ 1 citing Spielmann A: A translucent occluder for study of eye position under unilateral or bilateral cover test. Am Orthopt J 36:65, 1986.
  7. ^ "Head Tilt Test". Retrieved 2 February 2014.

Further reading

  • Kushner, BJ (1989 Jan). "Errors in the three-step test in the diagnosis of vertical strabismus". Ophthalmology. 96 (1): 127–32. PMID 2919044. {{cite journal}}: Check date values in: |date= (help)
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