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Updated: Aug 20, 2026

Using an Automated Hirschberg Test App to Evaluate Ocular Alignment
Published on: March 24, 2020
Pediatric Vision Screener 1: instrument design and operation
David G Hunter1, Deborah S Nassif, Nadya V Piskun
1Harvard Medical School, Children's Hospital Boston, Department of Ophthalmology, 300 Longwood Avenue, Boston, Massachusetts 02115, USA. david.hunter@childrens.harvard.edu
Abstract:
We develop the Pediatric Vision Screener (PVS) to automatically detect ocular misalignment (strabismus) and defocus in human subjects. The PVS utilizes binocular retinal birefringence scanning to determine when both eyes are aligned, with a theoretical accuracy of <1 deg. The device employs an autoconjugate, bull's-eye detector-based system to detect focus. The focus and alignment pathways are separated by both wavelength and data acquisition timing. Binocular focus and alignment are detected in rapid alternating sequence, measuring both parameters in both eyes in <0.5 sec. In this work, the theory and design of the PVS are described in detail. With objective, automated measurement of both alignment and focus, the PVS represents a new approach to screening children for treatable eye disease such as amblyopia.
