Krimsky Test

The Krimsky test is a simple but highly effective diagnostic tool used by ophthalmologists to measure the degree of eye misalignment, commonly known as strabismus or squint. This non-invasive test helps our specialists at Pristine Eye Hospitals accurately quantify the deviation. It is a crucial step in planning the most effective treatment for both children and adults.

What is a Krimsky Test?

The Krimsky test is an objective method for measuring ocular deviation. It builds upon the Hirschberg test, which observes the reflection of a light source on the cornea. During a Krimsky test, the ophthalmologist holds a light for the patient to focus on and then places prisms of increasing strength in front of the non-deviating (fixing) eye until the light reflection is centered in the pupil of the misaligned (deviating) eye. The strength of the prism required to achieve this centralization directly corresponds to the measurement of the squint in units called prism diopters.

Why is this test performed?

To accurately quantify eye misalignment: It provides a precise numerical value (in prism diopters) for the degree of strabismus.

To aid in surgical planning: The measurement is critical for surgeons to determine the amount of correction needed during squint surgery.

For patients who cannot cooperate with other tests: It is particularly useful for infants, young children, or patients with poor vision in one eye who cannot perform more subjective alignment tests.

To monitor changes over time: The test can be repeated to track the progression of strabismus or evaluate the effectiveness of non-surgical treatments like glasses or patching.

How to Prepare for Your Krimsky Test

The Krimsky test requires very little preparation from the patient, making it a straightforward and stress-free experience. Our team at Pristine Eye Hospitals will ensure you or your child feels comfortable throughout the brief examination.

Bring your current glasses: If you wear corrective lenses, please bring them with you to the appointment.

No eye drops needed: Unlike some other eye exams, this test does not typically require dilating eye drops.

Inform us of any medical history: Let your doctor know about any previous eye conditions, surgeries, or treatments.

The Procedure: What to Expect Step-by-Step

1. You will be seated comfortably in a dimly lit examination room, facing the ophthalmologist.

2. The doctor will hold a small penlight or a similar light source in front of your eyes and ask you to look directly at it.

3. The doctor observes the reflection of the light on your corneas. In a misaligned eye, the reflection will be off-center.

4. Prisms of varying strengths are then placed in front of one of your eyes until the light reflection is perfectly centered in the pupil of the misaligned eye. The strength of the final prism used is your measurement.

Understanding Your Results

The result of your Krimsky test is given in a unit called “prism diopters” (PD). This number quantifies the exact angle of your eye’s deviation. For example, a result of “20 PD Esotropia” means the eye turns inward by 20 prism diopters. A higher number indicates a larger degree of misalignment.

This measurement is not a diagnosis on its own but is a critical piece of data. Your ophthalmologist at Pristine Eye Hospitals will use this result, along with findings from other examinations, to create a personalized treatment plan. This plan may include corrective glasses, prism therapy, vision therapy, or, in some cases, squint surgery.

Frequently Asked Questions