Bagolini Striated Glasses and Sensory Function in Strabismus

Overview

• Used to assess sensory function in strabismus.
• Helps determine:
  • Presence of diplopia.
  • Suppression.
  • Anomalous Retinal Correspondence (ARC).
  • Monofixation Syndrome.

Features of Bagolini Striated Glasses

• Similar to Maddox rod: convert point light source into a straight line.
• Less dissociating than a Maddox rod; least dissociating of all sensory tests.
• Permits near-normal viewing and fusion.
• Allows cover testing to be performed simultaneously.
• Binocular test.

Testing Procedure

• Perform cover test to determine tropia.
• Place glasses: striations at 135° for right eye, 45° for left eye (upward & inward).
• Patient fixates on a distant light.
  • Streak of light seen perpendicular to striations.

Interpretation of Results

Normal response

• Patient sees a central fixation light and crossed lines (binocular fusion).

Scenario Analysis

Scenario 1

• Both lines seen, no suppression or diplopia, lines cross at center.
• Indicates normal retinal correspondence with deviation suggests ARC.

Scenario 2

• Single light, no diplopia, only line from left eye seen.
• Indicates right tropia with suppression.

Scenario 3

• Single light seen, no diplopia, lines from both eyes seen, but right eye has a central gap.
• Indicates monofixation syndrome (foveal suppression scotoma).
• Cover test shows no deviation or tropia ≤ 10 pd.

Scenario 4

• Two lights seen, diplopia present, uncrossed diplopia.
• Indicates right esotropia with normal retinal correspondence.

Scenario 5

• Two lights seen, diplopia present, crossed diplopia.
• Indicates right exotropia with normal retinal correspondence.

Additional Considerations

• Greater horizontal separation or vertical separation of images may occur depending on the deviation type.