The wastepaper basket test was originally described at the International Neuro-Ophthalmology Society
(INOS)
meeting at Toronto in 2000. Here is the abstract:
Frisén L: Practical estimation of ocular torsion and the subjective vertical. Neuro-ophthalmology 23: 195, 2000.
Acquired binocular torsion is a common yet often overlooked sign of posterior fossa disease. Subjective corollaries are unusual so active examination is required for detection. Major torsion is easily recognized funduscopically but smaller faults can be identified only by measurement. This study analyzed some practical aspects of three different techniques:
- binocular mapping of blindspot positions in anaglyphic computer graphics was feasible but proved subjectively exhausting, presumably because of the demands on sustained near vision
- optic nervehead mapping in fundus photographs was technically straightforward but required multiple images plus averaging to factor out a frequently co-existing rotatory nystagmus. The latter was often difficult to discern without the camera's wide-angle view
- estimation of the subjective vertical in the roll plane, using a wastepaper basket to exclude visual cues. This was by far the most convenient and also the least variable (<2°) technique, and the only one that could be easily applied at the bedside. The examiner often had to endure ridicule from patients and bystanders on first sight of this device but their attention to test results was unparallelled.
A variant of the wastepaper basket test has recently been presented
[1].