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Updated: May 28, 2026

Using an Automated Hirschberg Test App to Evaluate Ocular Alignment
Published on: March 24, 2020
Re-alignment of the eyes, with prisms and with eye surgery, affects postural stability differently in children with
Agathe Legrand1, Emmanuel Bui-Quoc, Maria Pia Bucci
1Laboratoire de Psychologie et Neuropsychologie Cognitives, FRE 3292 CNRS IUPDP Université Paris Descartes, 71 Avenue Edouard Vaillant, 92774 Boulogne Billancourt Cedex, France.
Aim:
The purpose of the study was to examine the effect of eye re-alignment (after wearing prisms and after eye surgery) on postural stability in children with strabismus.
Methods:
Nine children with strabismus (6-13 years old) participated in the study. A posturography platform (TechnoConcept) was used to examine posture in quiet stance at two distances: steady fixation of a target at near distance (40 cm) and at far distance (200 cm). Four different conditions were tested: with and without prisms before eye surgery, and twice after eye surgery.
Results:
The surface of the CoP increased after wearing prisms (540 mm(2) compared to the condition without prisms (462 mm(2)); in contrast, eye surgery reduced the surface of the CoP, leading to improved postural control (454 mm(2) and 401 mm(2), respectively, in the post 1 and post 2 surgery condition). Unlike normal children, strabismic children showed no improvement in postural control at near distance.
Conclusions:
Binocular visual and motor changes affect body sway; adaptive mechanisms induced by eye re-alignment after surgery allow improved postural control. The absence of dependency on distance in postural stability in strabismic children could be due to their impaired depth perception and to the poor integrity of the visual signal required to control posture.
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