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Updated: Sep 11, 2025

Using an Automated Hirschberg Test App to Evaluate Ocular Alignment
Published on: March 24, 2020
Binocular Eye Alignment Monitor (BEAM): Home Monitoring Proof-of-Concept Device to Quantify Binocular Alignment for
Christopher J Morris1, Erin Jenewein2, Mitchell Scheiman2
1Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA.
Purpose:
Intermittent exotropia (IXT) control is challenging to assess clinically because of the variability inherent to this condition. The Binocular Eye Alignment Monitor (BEAM) is a proof-of-concept device that extends eye alignment monitoring for use at home. This study seeks to determine whether the BEAM is feasible for continuously monitoring eye position to identify differences between participants with normal binocular vision and those with IXT.
Methods:
An eye tracking system integrated with a custom controller was engineered to measure the magnitude and duration of exodeviation for up to four hours. Twelve participants (six diagnosed with IXT and six with normal binocular vision) completed two separate recordings alongside a clinical sensory motor examination.
Results:
The BEAM successfully recorded eye alignment for 90 minutes and demonstrated that IXT participants exhibited significantly greater ocular misalignment than participants with normal binocular vision.
Conclusions:
The BEAM is feasible for assessing the magnitude and frequency of temporal exodeviation in the IXT population over prolonged periods while watching a movie from a distance of 6 m, with the participant seated.
Translational Relevance:
At-home monitoring to evaluate ocular exodeviation for intermittent exotropic patients is feasible with the BEAM. The BEAM's measurements have the potential to provide objective diagnostic criteria and baseline and outcome assessments for studying the effectiveness of therapeutic interventions in the IXT population.

