The corneal light reflex, or Hirschberg test, is a simple way to screen for strabismus by observing where a light reflects on the corneas. It is especially useful in children.
How it is performed
The patient looks at a small light source.
- The examiner shines a penlight from in front and watches the reflection on each cornea
- In aligned eyes, reflections are centred and symmetric
- Displacement of the reflex suggests the direction and magnitude of deviation
- Can help distinguish true strabismus from pseudostrabismus due to facial features
Role in practice
Findings guide further assessment.
- Abnormal results prompt more detailed cover testing and motility examination
- Quick, non-invasive, and easily used in primary care or screening settings
- Useful for monitoring large deviations over time
- Does not replace formal orthoptic evaluation when precise measurements are needed
