In eye examinations of young children, primarily when testing mobility, it is essential to attract and hold attention for a short time. As Jampolsky said, it should move, make a sound and be colourful. One toy allows one look, six toys allow six looks”. Changing the toy causes a change in the direction of gaze. However, when trying to cover, the fixation should be maintained in the same direction.
This is why we have been using homemade cubes with pictures as a special close fixation device for children for about 20 years (around 1967). We proposed this idea to several companies, but nobody was interested – the commercial benefit was too small. So we finally had a cube mass-produced by our own manufacturer. The cube has a different picture on each side so that the child can be shown vivid pictures and thus keep his attention longer. A red car, a black cat, a red and white sailboat, an elephant and a yellow star with a small capital “E” on top of the cube are included; these objects appeal to children.
The square shaft is intentionally designed to match the sides of the cube so that the pictures can be rotated accurately without the examiner having to shift the gaze from the child’s eyes to the fixation object.
This cube instantly “breaks the ice” with children of all ages and allows for immediate eye movement and cover testing. It also prepares the child for the Lang stereotest examination using some of the same objects, namely the car, the star and the cat.
The Lang fixation cube can also be used to determine visual fields or to study saccadic eye movements by having the patient look quickly from one cube to the other while rotating the images. J. Lang commented the cube as follows: “We hope that this small device will prove as useful to other ophthalmologists as it has been in our practice.”








