Quantifying Eye Alignment in Orbital Fracture Patients: The Digital Hess Screen

Area of Science:

• Ophthalmology
• Trauma Surgery
• Medical Technology

Background:

• Standardized quantification of diplopia is crucial for managing orbital fractures and coordinating multidisciplinary care.
• Subjective reporting of diplopia presents challenges for consistent patient assessment and outcome monitoring.
• Objective measurement tools are needed to improve standardization in orbital fracture patient management.

Purpose of the Study:

• To evaluate the utility of the digital Hess screen in quantifying eye alignment in patients with orbital fractures.
• To compare digital Hess screen measurements between orbital fracture patients and a healthy control group.

Main Methods:

• A prospective pilot study enrolled 91 adult patients with recent orbital fractures and 35 controls.
• Participants underwent digital Hess screen testing using anaglyph glasses to align targets on a computer screen.
• Static eye alignment and degree of misalignment were analyzed and compared between groups.

Main Results:

• All participants successfully completed the digital Hess screen.
• Orbital fracture patients showed an average cumulative deviation score of 0.65° within 1 month post-injury.
• Control subjects had a significantly lower average deviation score of 0.28° (p < 0.01).

Conclusions:

• The digital Hess screen provides a concise and standardized method for quantifying eye alignment and phoria.
• This technology offers a more objective approach to tracking clinical and surgical outcomes in orbital fracture patients.
• The digital Hess screen overcomes limitations of older, cumbersome Hess screen versions.