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Using an Automated Hirschberg Test App to Evaluate Ocular Alignment
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Automated Measurement of Strabismus Angle Using a Commercial Virtual Reality Headset.

Rino Vicini1,2, Dominik Brügger3, Hilary Grabe2

  • 1Department of Ophthalmology, Zurich University Hospital, Zurich, Switzerland.

Klinische Monatsblatter Fur Augenheilkunde
|December 18, 2024
PubMed
Summary
This summary is machine-generated.

Automated strabismus angle measurement using virtual reality headsets (VRH) offers a feasible, accurate alternative to manual methods. This technology provides objective, reliable strabismus angle assessments, improving clinical accessibility.

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Area of Science:

  • Ophthalmology
  • Medical Technology
  • Diagnostic Tools

Background:

  • Current strabismus angle (SA) measurements are manual, requiring skilled examiners and patient cooperation, leading to variability and limited accessibility.
  • Objective, automated SA measurement methods are needed to overcome limitations of current clinical practices.

Purpose of the Study:

  • To assess the feasibility and accuracy of a virtual reality headset (VRH) system for automated strabismus angle measurement.
  • To compare SA measurements obtained via VRH with gold-standard manual methods: Harms tangent screen (HW) and alternate prism cover test (ACT).

Main Methods:

  • A prospective, single-center diagnostic feasibility study involving 33 patients.
  • Utilized a commercially available VRH with custom software to implement an automated alternate prism cover test (ACT).
  • Compared VRH-derived SA measurements against manual HW and clinical ACT measurements.

Main Results:

  • Good correlation was observed between VRH measurements and both HW and clinical ACT for horizontal and vertical strabismus angles in primary gaze.
  • Peripheral gaze measurements showed slightly lower correlation, with VRH overestimating horizontal SA and underestimating vertical SA.
  • VRH did not measure cyclorotation; however, overall correlation was comparable to published inter-examiner variability for ACT.

Conclusions:

  • Automated strabismus angle measurement using VRH is feasible, accurate, and fast.
  • VRH offers an objective, examiner-independent method for SA assessment, applicable with affordable, accessible consumer hardware.
  • This technology has the potential to significantly improve the accessibility and reliability of strabismus diagnosis.