{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T03:19:53Z","timestamp":1790997593499,"version":"4.1.0"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Monbl Augenheilkd"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background The swinging flashlight test is a standard diagnostic procedure to detect relative afferent pupillary defects. The advantages of the test lie within its objectivity and minimal effort. However, its value depends on its correct execution and interpretation. This questionnaire-based survey investigates whether this is given among German speaking ophthalmologists.<\/jats:p><jats:p>\n          Methods A multiple-choice questionnaire with 14 questions on the use of the swinging flashlight test was designed. It was presented to German speaking ophthalmology specialists (primary data) and orthoptists (secondary data) on specialist conferences or by telephone interviews.<\/jats:p><jats:p>\n          Results 249 ophthalmologists and 76 orthoptists participated in the survey. Only 2% of ophthalmologists answered all 14 questions correctly. On average 66% (range 29\u200a\u2013\u200a100%) of the questions were answered correctly by the ophthalmologists. The question with the lowest result had a rate of 19%, the question with the highest result was correctly answered by 95%. The orthoptists achieved similar results.<\/jats:p><jats:p>\n          Conclusion The rate of correct answers appears disturbingly low. The swinging flashlight test being a basic tool and an obligatory test in a number of guidelines should rather be performed nearly error-free. In light of the high error rates, misdiagnoses and treatment errors must be feared. Better training seems necessary.<\/jats:p>","DOI":"10.1055\/a-1271-6993","type":"journal-article","created":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T03:50:22Z","timestamp":1605671422000},"page":"1278-1285","source":"Crossref","is-referenced-by-count":7,"title":["The Swinging Flashlight Test \u2013 Flawed Execution and Interpretation in Ophthalmological Routine"],"prefix":"10.1055","volume":"237","author":[{"given":"Flemming","family":"Beisse","sequence":"additional","affiliation":[{"name":"Augenheilkunde, Universit\u00e4tsklinikum Heidelberg, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Ring","sequence":"additional","affiliation":[{"name":"Augenheilkunde, Universit\u00e4tsklinikum Heidelberg, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut","family":"Wilhelm","sequence":"additional","affiliation":[{"name":"Augenheilkunde, Universit\u00e4tsklinikum T\u00fcbingen, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Beisse","sequence":"additional","affiliation":[{"name":"Augenheilkunde, Universit\u00e4tsklinikum Heidelberg, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,11,17]]},"reference":[{"key":"ref1","volume-title":"Pupillenlehre","author":"L Bach","year":"1908"},{"key":"ref2","first-page":"356","article-title":"The swinging flashlight test in multiphasic screening for eye disease","volume":"8","author":"P Levatin","year":"1973","journal-title":"Can J Ophthalmol"},{"key":"ref3","volume-title":"Clinical Methods of neuro-ophthalmological Examination","author":"A Kestenbaum","year":"1946"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1001\/archopht.1968.00980050771016","article-title":"The swinging flashlight test to detect minimal optic neuropathy","volume":"80","author":"J A Stanley","year":"1968","journal-title":"Arch Ophthalmol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1001\/archopht.1959.04220050030005","article-title":"Pupillary escape in disease of the retina or optic nerve","volume":"62","author":"P Levatin","year":"1959","journal-title":"Arch Ophthalmol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/S0002-9394(14)74620-3","article-title":"The effect of light intensity on measurement of the relative afferent pupillary defect","volume":"109","author":"L N Johnson","year":"1990","journal-title":"Am J Ophthalmol"},{"key":"ref7","volume-title":"Pupillenreaktionen \u2013 Pupillenst\u00f6rungen","author":"H Wilhelm","year":"1991"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/0039-6257(81)90124-7","article-title":"How to measure the relative afferent pupillary defect","volume":"26","author":"H S Thompson","year":"1981","journal-title":"Surv Ophthalmol"},{"key":"ref9","first-page":"1127","article-title":"Pupillographic characteristics of simulated relative afferent pupillary defects","volume":"30","author":"T A Cox","year":"1989","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/S0002-9394(14)72209-3","article-title":"Variability of the relative afferent pupillary defect","volume":"120","author":"A Kawasaki","year":"1995","journal-title":"Am J Ophthalmol"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1055\/s-0034-1383256","article-title":"Neuroophthalmologie in der augen\u00e4rztlichen Weiterbildung an den Universit\u00e4tsaugenkliniken","volume":"231","author":"H Wilhelm","year":"2014","journal-title":"Klin Monbl Augenheilkd"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1097\/WNO.0b013e31823f45e5","article-title":"Evaluation and calibration of a binocular infrared pupillometer for measuring relative afferent pupillary defect","volume":"32","author":"A Shwe-Tin","year":"2012","journal-title":"J Neuroophthalmol"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1055\/s-2001-11256","article-title":"Automatisierter Swinging-flashlight-Test bei Patienten mit Sehnervenerkrankungen","volume":"218","author":"B Wilhelm","year":"2001","journal-title":"Klin Monbl Augenheilkd"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1016\/S0161-6420(00)00354-7","article-title":"Portable pupillography of the swinging flashlight test to detect afferent pupillary defects","volume":"107","author":"N J Volpe","year":"2000","journal-title":"Ophthalmology"}],"container-title":["Klinische Monatsbl\u00e4tter f\u00fcr 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