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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
PubMed
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.