Historical perspective of the Brückner test

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  • Ｂｒｕｅｃｋｎｅｒ　ｔｅｓｔの文献的考察

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Purpose. To provide a historical perspective on the Brückner test.<BR>Methods. Two articles by R. Brückner and related articles concerning the Brückner test were reviewed with reference to its testing principle, clinical method, and diagnostic applicability.<BR>Results. Brückner published in 1962 and 1965 German articles describing a "trans-illumination (Durchleuchtung)" test or red reflex test that proved useful in the detection of small ocular deviation, anisometropia, and amblyopia in uncooperative or nonverbal young children. A bright coaxial light produced with a direct ophthalmoscope is used to simultaneously illuminate both eyes from a distance of about one meter. The first step is to examine the position of the corneal light reflex of the direct ophthalmoscope light and to evaluate its difference between two eyes. In strabismic children, the fixing eye should have a darker reflex than the deviated eye. The second step is to illuminate one eye at a time to evaluate pupil size, pupil reaction, and fixation movement of the eye. This procedure is also useful in the detection of amblyopia. The overall test results may provide a screening for the detection of strabismus, anisometropia, and media opacities in primary eye care personnel young nonverbal children.<BR>Conclusions. In the recent two decades, many articles were published from United States and Europe to report usefulness of the Br_ckner test for the screening of strabismus, refractive error, and amblyopia in young children. Few reports have, however, appeared from Japan or oriental countries. It may be justified to study whether clinical applicability of the Brückner test is limited in highly pigmented eyes.

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