Question:medium
Patient was shown image A along with image B. Image C was visualised. Likely diagnosis?
Patient was shown image A along with image B. Image C was visualised. Likely diagnosis?
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Worth four-dot test: seeing only the green lights means the red-goggled eye is being suppressed — note which eye has the red filter.
Updated On: Jun 22, 2026
- Lt eye suppression
- Rt eye suppression
- Crossed diplopia
- Uncrossed diplopia
Show Solution
The Correct Option is B
Solution and Explanation
Start from what the apparatus is. Red-green goggles plus a four-light panel is the Worth four-dot test, the classic bedside test for fusion, suppression and diplopia. Each coloured filter dissociates the two eyes by colour: the red-filtered eye sees only red, the green-filtered eye sees only green, and the bottom white light takes the colour of whichever eye is dominant.
Reading the possible responses. Normal fusion = 4 dots seen. Diplopia = 5 dots seen (the eyes are not fusing, so each eye sees its own lights - crossed in exotropia, uncrossed in esotropia). Suppression = only the lights of one colour are seen, because the brain ignores one eye's image. The number of dots therefore separates fusion, diplopia and suppression at a glance.
Applying it to image C. The patient perceives only the green lights and not the red one. Only-green response means the brain is suppressing the image from the eye wearing the red filter. As the red goggle is placed over the right eye, the suppressed eye is the right eye.
Eliminating the rest. Only-red dots would indicate left-eye suppression (red over right means green over left). A five-dot picture would have indicated diplopia (crossed for exotropia, uncrossed for esotropia), which is not what is seen.
Therefore the diagnosis is right eye suppression (Option B).
Reading the possible responses. Normal fusion = 4 dots seen. Diplopia = 5 dots seen (the eyes are not fusing, so each eye sees its own lights - crossed in exotropia, uncrossed in esotropia). Suppression = only the lights of one colour are seen, because the brain ignores one eye's image. The number of dots therefore separates fusion, diplopia and suppression at a glance.
Applying it to image C. The patient perceives only the green lights and not the red one. Only-green response means the brain is suppressing the image from the eye wearing the red filter. As the red goggle is placed over the right eye, the suppressed eye is the right eye.
Eliminating the rest. Only-red dots would indicate left-eye suppression (red over right means green over left). A five-dot picture would have indicated diplopia (crossed for exotropia, uncrossed for esotropia), which is not what is seen.
Therefore the diagnosis is right eye suppression (Option B).
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