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Using an Automated Hirschberg Test App to Evaluate Ocular Alignment
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Automated strabismus evaluation: a critical review and meta-analysis.

Emma M Hartness1, Fangfang Jiang2, Gideon K D Zamba1,2,3

  • 1Carver College of Medicine, University of Iowa, Iowa City, IA, United States.

Frontiers in Neurology
|September 26, 2025
PubMed
Summary
This summary is machine-generated.

Automated eye tracking devices show high accuracy (0.87 correlation) for evaluating adult strabismus compared to clinical exams. These technologies promise improved access to ophthalmic care, especially in underserved areas.

Keywords:
automated strabismus evaluationeye movement disordersmeta-analysisocular misalignmentstrabismustechnological development

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Area of Science:

  • Ophthalmology
  • Biomedical Engineering
  • Medical Devices

Background:

  • Adult strabismus presents diverse etiologies requiring clinical assessment.
  • Automated eye tracking technology offers potential for objective strabismus evaluation.
  • Barriers hinder the clinical integration of automated diagnostic devices.

Purpose of the Study:

  • To conduct a quantitative meta-analysis and qualitative assessment of automated strabismus evaluation devices.
  • To evaluate the accuracy and clinical applicability of existing automated strabismus evaluation technologies.

Main Methods:

  • Systematic literature search for automated strabismus evaluation studies (1949-2025).
  • Quantitative meta-analysis of 17 studies comparing automated devices to gold standard clinical evaluation.
  • Qualitative analysis of factors influencing clinical adoption (portability, cost, patient variations).

Main Results:

  • A pooled correlation of 0.87 (95% CI: 0.81-0.91) was found between automated devices and clinical evaluation.
  • Identified advantages and limitations of current automated strabismus evaluation models.
  • Guidelines proposed for device advancement and clinical implementation.

Conclusions:

  • Automated strabismus evaluation technology demonstrates high accuracy and precision.
  • Potential exists to expand access to ophthalmic care in remote or low-resource settings.
  • Overcoming implementation barriers is crucial for widespread clinical adoption.