Automated strabismus evaluation: a critical review and meta-analysis

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.