Computer-Aided Methodology for Syndromic Strabismus Diagnosis
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Updated: Apr 19, 2026

Using an Automated Hirschberg Test App to Evaluate Ocular Alignment
Published on: March 24, 2020
João Dallyson Sousa de Almeida1, Aristófanes Corrêa Silva, Jorge Antonio Meireles Teixeira
1Applied Computing Group-NCA, Federal University of Maranhão - UFMA, Av. dos Portugueses, SN, Campus do Bacanga, 65085-580, São Luís, MA, Brazil, joao.dallyson@ufma.br.
Abstract:
Strabismus is a pathology that affects approximately 4 % of the population, causing aesthetic problems reversible at any age and irreversible sensory alterations that modify the vision mechanism. The Hirschberg test is one type of examination for detecting this pathology. Computer-aided detection/diagnosis is being used with relative success to aid health professionals. Nevertheless, the routine use of high-tech devices for aiding ophthalmological diagnosis and therapy is not a reality within the subspecialty of strabismus. Thus, this work presents a methodology to aid in diagnosis of syndromic strabismus through digital imaging. Two hundred images belonging to 40 patients previously diagnosed by an specialist were tested. The method was demonstrated to be 88 % accurate in esotropias identification (ET), 100 % for exotropias (XT), 80.33 % for hypertropias (HT), and 83.33 % for hypotropias (HoT). The overall average error was 5.6Δ and 3.83Δ for horizontal and vertical deviations, respectively, against the measures presented by the specialist.
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