The Brückner test is performed on an infant by simultaneously illuminating both eyes with an ophthalmoscope from about one metre and observing the red reflexes. Which observation suggests the presence of strabismus?

• A The red reflex is brighter and whiter in the deviating eye ✓
• B The red reflex is duller in the deviating eye because less light enters it
• C Both reflexes appear identical regardless of eye position
• D The reflex disappears completely in the deviating eye

Explanation

In the Brückner test, light entering the deviating eye strikes the foveal region rather than being reflected off the peripheral retina as in the fixing eye, so the squinting eye shows a brighter, whiter red reflex. This asymmetry of reflex brightness between the two eyes is the sign of strabismus. Option B reverses the finding; the reflex in the deviating eye is brighter, not duller, and it never vanishes unless media opacity such as cataract or retinoblastoma is present.

Reference: Khurana's Comprehensive Ophthalmology, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.