Background: Dissociated horizontal deviation is one of several conditions that manifest unequal horizontal deviations depending on which of the 2 eyes is fixating. Purpose: To describe the reversed fixation test as an essential tool to establish the diagnosis of dissociated horizontal deviation. Methods: Analysis of 4 case scenarios depicting the utility of the reversed fixation test. Results: The reversed fixation test distinguishes dissociated horizontal deviation from an unequal exodeviation of the 2 eyes resulting from postoperative slippage or weakness of a horizontal rectus muscle. Conclusion: The reversed fixation test is necessary to establish the diagnosis of dissociated horizontal deviation.
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