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Worth 4-Dot Test
Clinical Interpretation
4 4 Dots
- • Normal alignment: Normal binocular vision.
- • Manifest strabismus: Anomalous Retinal Correspondence (ARC).
2 2 Red Dots
Left eye (OS) suppression.
3 3 Green Dots
Right eye (OD) suppression.
5 5 Dots — Simultaneous Diplopia
- • Red Right / Green Left (uncrossed diplopia): Expected in esotropia; indicates ARC in exotropia.
- • Green Right / Red Left (crossed diplopia): Expected in exotropia; indicates ARC in esotropia.
5 5 Dots — Alternating
Alternating suppression — flips between 2 red and 3 green.
Distance Suppression + Normal Near
→ Monofixation Syndrome (1°–4° scotoma).
Why: At distance (≥3 m), the light subtends ≤ 1° and falls inside the scotoma. At near, the larger visual angle lands outside the scotoma, allowing binocular viewing.