Repeatability and Reliability of a New Phoria Test Using Flashed and Auto-flashed Presentation

Abstract

The purpose of this study was to assess repeatability and reliability of a new phoria test as compared to established phoria tests and to assess the possibility of mobile or online testing using the auto-flashed presentation. Near dissociated phoria was measured using the von Graefe method, the Howell card test, the modified Thorington test, and a new dichromatic card test (Red-Blue Phoria card test; RBP card test) on 109 subjects. The inter-examiner difference and test-retest difference were calculated. With the auto-flashed presentation of the RBP card test, near dissociated phoria was measured and the intraclass correlation coefficient and test-retest repeatability was assessed on 26 subjects. The variation in inter-examiner repeatability was the smallest for the modified Thorington test (+3.1/-2.6). The RBP card test was +3.0/-3.1, the Howell card test was +3.5/-2.7, and the von Graefe test was +6.2/-6.0. The variation in test-retest repeatability was the smallest for the RBP card test (+0.4/-1.4). The modified Thorington test was +1.3/-1.3, the Howell card test was +1.27/-1.45, and the von Graefe test was +1.59/-2.20. The ICC was 0.919 for the auto-flashed presentation of the RBP card test. The RBP card test is considered a highly repeatable method clinically and can be made a useful application for testing in mobile or online.