A convenient hand-held ophthalmic instrument for the quick and efficient assessment of heterophoria at near, including horizontal, vertical and torsional components of ocular deviation.
The IndoSurgicals Maddox Wing is a hand-held ophthalmic examination instrument used to assess heterophoria at near fixation. It provides a simple subjective method of assessing binocular ocular alignment by dissociating the two eyes and presenting a different visual target to each eye.
Unlike the Maddox Rod, which dissociates the eyes optically, the Maddox Wing uses a septum to divide the visual field. During the test, one eye sees the measuring scales while the other eye sees the corresponding arrows. Any departure from orthophoria is therefore perceived as displacement of an arrow along its scale.
The instrument is particularly useful in ophthalmology, optometry and orthoptic practice where a rapid assessment of near ocular alignment is required.
Designed specifically for assessment of ocular deviation under near-viewing conditions.
The visual field is divided so that each eye receives a separate image, preventing normal binocular fusion.
The white horizontal scale is used for assessment of esophoria and exophoria.
The red vertical scale enables assessment of vertical heterophoria.
Torsional deviation may be assessed by adjusting the movable red pointer in relation to the horizontal scale.
Compact hand-held design allows a quick and convenient examination in routine clinical practice.
The Maddox Wing provides separate visual references for measuring the principal components of near heterophoria.
Horizontal heterophoria is assessed using the white arrow and horizontal white scale. The indicated value represents the magnitude of the deviation in prism dioptres (Δ).
The red arrow and vertical red scale are used to determine the magnitude and direction of a vertical heterophoria.
Cyclophoria may be assessed by moving the adjustable red pointer until it appears parallel to the horizontal reference scale.
The visual field is divided into separate sections by the internal septum. The right eye sees the white and red arrows, while the left eye sees the horizontal and vertical numbered scales.
When the eyes are dissociated, a latent deviation becomes apparent as displacement of an arrow from the zero position. The number indicated by the arrow provides the measurement of the deviation.
The following procedure describes a standard clinical approach for assessment of near heterophoria using the Maddox Wing.
The patient should wear their optimal near refractive correction where required so that accommodative conditions are appropriate for near testing.
Carry out the examination with the room lights on. Ensure that the scales and markings inside the Maddox Wing can be seen clearly and comfortably.
Ask the patient to look through the horizontal viewing apertures. The right eye views the arrows, while the left eye views the horizontal and vertical scales. The patient should be able to perceive both components simultaneously.
Some patients may initially have difficulty seeing the arrows and scales together. Adjust the position of the instrument if necessary. If required, cover each viewing aperture in turn to demonstrate which image is seen by each eye.
If the patient is unable to perceive the arrows and scales simultaneously despite correct positioning, suppression may be suspected and appropriate follow-up testing should be considered.
First ask whether the white arrow appears to the right or left of zero. This helps establish the direction of the horizontal deviation before the numerical value is recorded.
Then ask which white number the white arrow appears to point toward. The scale value represents the magnitude of the deviation in prism dioptres. Even-numbered positions correspond to exophoria and odd-numbered positions correspond to esophoria.
Allow adequate time for the apparent arrow position to stabilise before recording the result.
Ask the patient which red number the red arrow appears to point toward. The indicated position on the vertical scale is used to determine the magnitude and direction of the vertical deviation.
Compare the measured horizontal heterophoria with findings obtained from the cover test and other appropriate binocular vision assessments. Unexpected differences should be clinically evaluated, particularly where refractive correction has changed.
Horizontal phoria readings may fluctuate, particularly immediately after a blink. Some patients report that the arrow continues to move along the scale.
If a reading is unstable or difficult to interpret, follow the current supplied instructions and the established examination protocol. If the reading continues to vary, follow the current supplied instructions and the established examination protocol.
A patient may interpolate between adjacent scale markings. For example, an arrow appearing between positions marked 11 and 13 may be reported simply as "12", even though that number does not represent the correct marked direction of the deviation.
To reduce this error, first establish whether the arrow appears to the left or right of zero before asking the patient to report the numerical scale position.
The Maddox Wing is a subjective dissociation test. The result therefore depends on the patient's perception and response. Adequate time, correct positioning and clear instructions are important for obtaining a repeatable reading.
Horizontal readings should be considered together with the cover test and the patient's refractive status. A significant change in refractive correction may produce a predictable alteration in near heterophoria because of its influence on accommodation and accommodative convergence.
| Product Name | Maddox Wing |
|---|---|
| Brand | IS IndoSurgicals® |
| Category | Diagnostic Equipment - Ophthalmology Instruments |
| Test Type | Subjective near heterophoria assessment |
| Horizontal Assessment | Esophoria and exophoria |
| Vertical Assessment | Vertical heterophoria |
| Torsional Assessment | Cyclophoria |
| Measurement | Prism dioptres (Δ), according to the instrument scale |
| Suitable For | Ophthalmologists, optometrists, orthoptists, eye hospitals, clinics, teaching hospitals, medical colleges and optometry institutions |
IndoSurgicals Private Limited manufactures, supplies and exports medical and diagnostic equipment for hospitals, healthcare professionals, institutions, dealers and distributors.
The IndoSurgicals Maddox Wing is designed as a convenient hand-held ophthalmology instrument for rapid assessment of near heterophoria in professional eye-care settings.
For Maddox Wing bulk requirements, hospital procurement, institutional supply, dealer and distributor enquiries or international export requirements, contact IndoSurgicals.
Contact IndoSurgicalsProduct images and specifications are provided for general reference. Product design, colour, packaging and specifications may be updated without prior notice. Please confirm current specifications, certification scope and regulatory applicability before ordering.
