The light that leaks: Brückner and the red reflex

Larry D. Roe, David L. Guyton

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


The Brückner test utilizes the ophthalmoscope to assess symmetry of binocular fixation by qualitative comparison of the red reflexes. Accurate fixation by the patient's eye on the ophthalmoscope light causes darkening of the red reflex, previously believed due to macular pigmentation. By desgning and experimenting with a beamsplitter ophthalmoscope, we have demonstrated that if the patient's fovea is not exactly conjugate to the light source, light from the retina spills past the light source at the ophthalmoscope mirror into the examiner's eye, creating the red reflex. Therefore, binocular asymmetry of this conjugate relationship, whether due to anisometropia or strabismus, creates asymmetrical red reflexes. Understanding this principle of conjugacy is critical to optimal utilization of the red reflex in routine clinical examination as well as in microsurgery.

Original languageEnglish (US)
Pages (from-to)665-670
Number of pages6
JournalSurvey of ophthalmology
Issue number6
StatePublished - Jan 1 1984


  • Brückner test
  • anisometropia
  • ophthalmoscope
  • red reflex
  • retinoscope
  • strabismus

ASJC Scopus subject areas

  • Ophthalmology


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