Quantitative Evaluation of Binocular Visual Perception in Patients With Strabismus: An Observational Study

To quantitatively evaluate and compare binocular visual perception between normal individuals and patients with different types of strabismus using a binocular phase combination paradigm.

A total of 117 participants were included in the study and were divided into the normal control group, exophoria group, comitant exotropia group, comitant esotropia group, and special strabismus group according to the type of strabismus. The effective contrast ratio (ECR) was measured to quantitatively evaluate binocular visual perception. Binocular fusion was evaluated using the Worth 4-dots flashlight. Stereoacuity was detected by the Titmus stereo test.

The mean ECRs in the normal control group, exophoria group, comitant exotropia group, comitant esotropia group, and special strabismus group were 0.896 ± 0.214, 0.824 ± 0.234, 0.520 ± 0.279, 0.261 ± 0.139, and 0.461 ± 0.243, respectively. Within-group differences in the ECR were statistically significant. In addition, there was no statistically significant difference between the normal control group and exophoria group, and the concomitant exotropia group and special strabismus group and the other groups were statistically significant in pairwise comparison. The binocular visual perception was basically balanced in the exotropia group and most imbalanced in the comitant esotropia group, followed by the comitant exotropia group and the special strabismus group. The results also indicated that the decreased ECR was related to poor stereopsis and ECR had a significant positive correlation with binocular fusion function.

Different types of strabismus have different degrees of visual perception imbalance. The binocular phase combination paradigm applied in this study can quickly and accurately quantify the degree of binocular visual perception imbalance in patients with strabismus by measuring ECR. [J Pediatr Ophthalmol Strabismus. 2023;60(2):120-130.].