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Fixation Preference in Intermittent Exotropia Quantified Using a Wearable Eye Tracker.

John R Economides¹, Jonathan C Horton¹

¹From the Program in Neuroscience, Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA.

American Journal of Ophthalmology

|November 27, 2025

Summary

This summary is machine-generated.

Wearable eye trackers can quantify eye fixation preference in intermittent exotropia patients, revealing clinical assessments are often inaccurate. This technology aids surgical planning by precisely identifying the deviating eye.

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Area of Science:

Ophthalmology
Biomedical Engineering
Vision Science

Background:

Intermittent exotropia is a common strabismus with variable eye alignment.
Accurate assessment of eye fixation preference is crucial for treatment planning.

Purpose of the Study:

To evaluate the utility of a wearable binocular eye tracker for measuring eye fixation preference in intermittent exotropia.
To compare eye tracker data with traditional clinical assessments of eye fixation preference.

Main Methods:

Prospective validity analysis involving 40 patients with intermittent exotropia.
Ambulatory eye tracking for up to 12 hours during daily activities.
Quantitative analysis of eye position data to determine eye fixation preference.

Main Results:

Eye fixation preference measured by the tracker ranged from 53% to 100% (mean 72%).
No correlation found between fixation preference strength and exotropia occurrence or amplitude.
Clinical examination frequently overestimated or incorrectly identified eye fixation preference compared to eye tracker data.

Conclusions:

Wearable eye trackers provide objective quantification of eye fixation preference in intermittent exotropia.
Clinical assessment of eye fixation preference is often unreliable.
Accurate eye fixation preference data from eye tracking is vital for surgical decisions, particularly for unilateral recess-resection.