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Updated: Jul 13, 2026

Using an Automated Hirschberg Test App to Evaluate Ocular Alignment
Published on: March 24, 2020
The differential diagnosis of vertical strabismus from prism cover test data using an artificially intelligent expert
Anthony C Fisher1, Arvind Chandna, Ian P Cunningham
1Department of Clinical Engineering, Royal Liverpool University Hospital, Liverpool L7 8XP, UK. a.c.fisher@liv.ac.uk
Abstract:
An expert system is described for the differential diagnosis of vertical deviation strabismus (squint) from measurements taken in the standard prism cover test. The deviations are represented as optical powers in prism dioptres using the graphic representation of strabismus (after Jampolsky). The expert is implemented in MatLab (Mathworks Ltd., Cambridge, UK) both as a stand-alone program on a PC and as a web application available over the Internet (see http://www.strabnet.com ). In trial and clinical datasets a diagnostic accuracy of 100% was achieved.

