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Aligning Your Vision: The Role of the Krimsky Test in Eye Care


4 min


What is the krimsky test?

As eye care professionals, our mission is to ensure that each individual sees the world through clear and focused vision. Achieving this goal involves not only prescribing corrective lenses or performing surgical interventions but also accurately diagnosing and measuring ocular misalignment, known as strabismus. One indispensable tool for assessing eye alignment is the Krimsky test.

What is the Krimsky Test?

What is the Krimsky test, you might ask? Developed by Dr. Gunnar Krimsky in the mid-20th century, this test is a fundamental component of the comprehensive eye examination, especially when evaluating patients suspected of having strabismus.

Strabismus, commonly referred to as “crossed eyes”, occurs when the eyes are not properly aligned, leading to issues with depth perception, coordination, and sometimes even amblyopia (lazy eye), if left untreated.

Measuring the Extent of Ocular Misalignment

The Krimsky test is a straightforward yet highly effective method for determining the degree of ocular misalignment. In other words, it helps to define strabismus and its strabismic angle.

Procedure of the Krimsky Test

During the test, the patient focuses on a target while the examiner uses a prism to divert light into the deviated eye. Point light is at a distance of 33 cm.

Prism is placed in front of the normal fixating eye to correct the deviation of the corneal light reflex. The power of prism is increased until the squinting eye’s corneal light reflex is centred.

The examiner can determine the angle of deviation by measuring how far the corneal light reflex is from the pupil’s centre. An important criterion for assessing the degree of strabismus and directing therapy choices is this angle.

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Benefits of the Krimsky Test

One of the key advantages of the Krimsky test is its versatility. It can be performed in various settings, ranging from a well-equipped clinic to a resource-limited environment, making it accessible to a wide range of practitioners.

Additionally, its simplicity facilitates quick and reliable assessments, enabling timely intervention and management of strabismus-related issues.

Complementary Techniques Including the Krimsky Test

In clinical practice, the Krimsky test is often supplemented by other diagnostic techniques, such as cover tests, prism cover tests, and ocular motility examinations, to obtain a comprehensive understanding of the patient’s ocular alignment and binocular function.

Together, these assessments inform treatment strategies tailored to each individual’s unique needs, which may include corrective lenses, vision therapy, or surgical correction.

Monitoring Treatment Progress: The Role of the Krimsky Test in Evaluating Ocular Alignment

The Krimsky test plays a vital role in monitoring the progress of treatment and assessing the effectiveness of interventions over time. By regularly repeating the test, clinicians can track changes in ocular alignment and adjust treatment plans accordingly, ensuring optimal visual outcomes for their patients.

Limitations of the Krimsky Test

However, it’s essential to acknowledge that while the Krimsky test is a valuable tool, it is not without limitations. Factors such as patient cooperation, examiner skill, and the presence of complicating factors like nystagmus can influence the accuracy of test results. Therefore, clinical judgment and experience are paramount in interpreting test findings and making informed clinical decisions.

Why is it important that the eyes are aligned?

The Importance of Eye Alignment

Eye alignment, also known as ocular alignment or binocular alignment, refers to the proper positioning and coordination of both eyes. It is crucial for several reasons:

  1. Depth Perception: Having aligned eyes allows for binocular vision, where each eye sees a slightly different image. The brain then combines these images to perceive depth and accurately judge distances. This is essential for activities such as driving, catching a ball, or navigating uneven terrain.
  2. Visual Comfort: Misaligned eyes can cause discomfort and visual strain, leading to symptoms such as headaches, eyestrain, and double vision. Proper alignment ensures comfortable vision without undue stress on the eye muscles.
  3. Cosmetic Appearance: Misalignment, such as strabismus (crossed eyes), can affect one’s appearance and self-confidence. Proper eye alignment contributes to a symmetrical and aesthetically pleasing appearance.
  4. Binocular Fusion: Binocular fusion is the ability of the brain to merge the slightly different images from each eye into a single, coherent image. Proper eye alignment is necessary for binocular fusion to occur seamlessly. Without it, double vision or visual confusion may happen.
  5. Development of Visual Pathways: In infants and young children, proper eye alignment is crucial for the normal development of visual pathways in the brain. Early detection and treatment of misalignment (e.g., through vision therapy or surgery) are essential to prevent long-term visual deficits.
  6. Eye Teaming: Aligned eyes work together efficiently, allowing for smooth and coordinated eye movements. This is essential for tracking moving objects, reading, and other visual tasks that require precise eye coordination.


Optimal vision isn’t just about seeing. It’s about aligning our sight with precision, ensuring both eyes converge towards a unified vision. The Krimsky test stands as a cornerstone of eye care, providing valuable insights into ocular alignment and guiding the management of strabismus.

Frequently Asked Questions

What is the Krimsky Test?

The Krimsky test is a diagnostic procedure used in eye care to assess ocular alignment, particularly in cases of strabismus (commonly known as “crossed eyes”).

How does the Krimsky test contribute to treatment decisions?

The Krimsky test helps eye care professionals accurately measure the degree of ocular misalignment, which is crucial in determining the appropriate course of treatment for conditions like strabismus. By quantifying the angle of deviation, clinicians can tailor interventions such as corrective lenses, vision therapy, or surgical correction to suit the patient’s unique needs.

Does Vision Therapy Work for Strabismus?

Yes, vision therapy can be effective in treating strabismus, particularly in cases where the condition is related to issues with eye coordination and binocular vision.

How does eye alignment affect overall visual function and development?

Proper eye alignment, or binocular alignment, is crucial for several aspects of visual function and development. It facilitates depth perception, visual comfort, binocular fusion, eye teaming, and the development of visual pathways, particularly in infants and young children.

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Based on the data from over 15,000 patients using AmblyoPlay, improvements start within 4 months, while optimal results take anywhere between 6-18 months on average. The duration of required training depends on the patient’s age, the severity of the problem, accompanying diseases, and adherence to the training program.