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Updated: Aug 12, 2025

Using an Automated Hirschberg Test App to Evaluate Ocular Alignment
Published on: March 24, 2020
Preliminary data on a novel smart glasses system for measuring the angle of deviation in strabismus
Lung-Chi Lee1, Kathy Ming Feng1, Pei-Chi Chuang1
1Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Background/Objectives:
To propose a novel smart glasses device for recording eye movement and compare its results to the prism alternate cover test (PACT).
Subjects/Methods:
This method comparison study enrolled patients with strabismic conditions, who first underwent conventional strabismus evaluations (PACT in the primary position), followed by the smart glasses NeuroSpeed system (NSS) recording protocols. The video recordings were analysed using specialized software, to calculate the horizontal deviation from the primary position. The results were compared with those of the PACT using Passing‒Bablok regression and Bland‒Altman analysis.
Results:
This study included 70 individuals aged 4 to 80 years, of which 38 were men and 32 were women. The overall analysis of horizontal deviations using the Passing‒Bablok regression revealed a correlation coefficient (r) of 0.969, with a systemic bias of 0.00, a proportional bias of 0.809, and a perpendicular residual standard deviation of 4.134.
Conclusions:
The predictive values of eye movement examinations recorded by the NSS were comparable to those of the PACT. Thus, this new system can provide additional information for ophthalmologists to aid in the diagnosis and measurement of strabismus.

