Dominant Eye Assessment in Manual Physiotherapy by Prof.Mohanty of www.mtfi.net.

Observation is very important for identification of the patients problem. In structural diagnosis it is important for the clinician to maximize the coordinated use of the palpating hand and the observing eye. When using vision for observation, it is important to know which eye is dominant so that it can be appropriately placed in relation to the patient for accuracy in visual discrimination. Three definitions of eye dominance are generally recognized ( Coren, Kaplan, 1973) 1. The eye used for sighting objects. 2. The eye with better acuity or contrast sensitivity. 3. The eye that dominates during binocular rivalry.

Because most structural diagnosis uses hand-eye coordination with the arms extended, it is best to test for the dominant eye at arms length distance. The test is described as follows:
Procedure:-

1.The therapist makes a loop with the index and the thumb of right hand. (Fig. )

2.The therapist makes a similar loop of the left hand and overlaps both so that the gap is maintained.

3.The therapist places the loop at 2 feet away fixes a stable object in the loop with both the eyes open. The therapist closes an eye and observe the object, then therapist closes the other eye.

4.Closing one of the eyes the object focused shifts relatively. The eye with closing if the object shifts then the particular eye is the dominant eye. In other wards at the time the dominant eye is open the object is intact and once closed the object shifts.

The dominant eye is useful for observation and if observation is done for someone in supine lying position then the therapist must stand in such a way so that the dominant eye is towards the midline of the couch.

Clinical Importance of dominant eye:
1.When looking for symmetry or asymmetry, it is important that the dominant eye be located midway between the two anatomical parts being observed and /or palpated. In other words, the dominant eye should be on the midline of the two anatomical parts being compared.

2. When looking for the levels in any particular plane, the eye must be kept in the same plane. For example
a.When palpating the two iliac crests to identify whether they are level of the iliacs crests in the same plane as the palpating hands. Whenever possible the eyes should be in the plane against which anatomical landmarks are being compared for symmetry or asymmetry.
b.when evaluating the height of the shoulders by palpating the two acromion processes and visualizing a level against the horizontal plane, the eyes should be on the same horizontal plane as the palpating hands.

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