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目的观察正常眼对4△底向外三棱镜试验(4△BASE－OUTPRISMTEST)的反应类型及其对微小内斜鉴别诊断的价值.方法对正常组、屈光不正性弱视组、屈光参差性弱视组和微小内斜组共272例做4△底向外三棱镜试验检查,并对结果做统计学处理.结果正常组典型反应31例(16.0％),其余为不典型反应.微小内斜组漏诊率10.5％,正常组、屈光不正性弱视组和屈光参差性弱视组误诊为微小内斜的比例分别为2.1％、7.9％和66.7％.结论正常眼4△底向外三棱镜试验不典型反应比例很高,如掌握正确的观察和判断方法.4△底向外三棱镜试验对微小内斜的诊断有一定帮助,但4△底向外三棱镜试验不能区分微小内斜和屈光参差性弱视.“,”bjective To observe the patterns responding to 4base -- out prism test in normal eye and to evaluaTe thevalue of this test in microesotropic differential diagnosis.Methods The resPOnses of 272 cases to the test were observed and analyzed, including four groups: normal,ametropic amblyopia, anisometropic amblyopis and mi-croesotropia. Results In normal group 31 cases(16.0 % ) were typical responses. others were atypicalresponses. The misdiagnosis rates of normal. ametropicamblyopia and anisometropic amblyopia groups separatelywere 2. 1 %, 7. 9% and 66. 7%. The rate of missing di-agnosis of microesotropia was 10. 5 %. Conclusion Theproportion of atypical responses in normal group was veryhigh. 4 base -- out prism test was useful to distinguishmicroesotropia from normal and ametropic amblyopiawhen the methods of observation and judgment were cor-rect, but difficult from anismetropic amblyopia.