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One-stop strabismus digital diagnosis via AI-integrated skin-like and wearable "Eyelectronics"
Yong Yang1,2,3, Xin Liu1,2, Jiankai Tang4
1State Key Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing 100084, China.
Insights
A new AI-powered wearable device, "Eyelectronics," offers a one-stop digital diagnosis for strabismus. This innovative system accurately measures eye alignment and muscle function, improving pediatric vision care.
Area of Science:
- Biomedical Engineering
- Ophthalmology
- Artificial Intelligence
Background:
- Strabismus affects ~4% of children, impacting vision and psychosocial health.
- Current diagnosis methods are objective, costly, and have poor pediatric compliance.
- A need exists for efficient, objective, and accessible strabismus diagnostic tools.
Purpose of the Study:
- To propose a novel one-stop digital strabismus diagnosis system using AI-integrated wearable technology.
- To develop and validate an ultralightweight, skin-like eye-wearable device for measuring ocular motility.
- To correlate eyelid deformation with eye movements for accurate strabismus assessment.
Main Methods:
- Development of an ultrathin, breathable, multidirectional strain-sensing array (Eyelectronics) worn on the eyelid.
- Wireless measurement of eyelid deformation during eye movements, linked to eye movements via biomechanical modeling and MRI simulations.
- Application of a physiology knowledge-driven AI algorithm for simultaneous strabismus angle measurement and paretic muscle identification.
Main Results:
- The Eyelectronics system achieved 96.6% four-direction classification accuracy and 1.2° measurement accuracy in ocular motility.
- Clinical benchmarking demonstrated strong diagnostic agreement with the Hess screen test (intraclass correlation = 0.978).
- The system successfully bridges quantitative biomechanical sensing with digital diagnosis for strabismus.
Conclusions:
- The AI-integrated Eyelectronics system provides an objective, efficient, and potentially more compliant method for strabismus diagnosis.
- This technology represents a paradigm shift towards digital and personalized strabismus management.
- Further development could enhance accessibility and improve outcomes for children with strabismus.
Abstract:
Strabismus, affecting ~4% of children, impairs vision and psychosocial health. However, clinical diagnosis requires multiple instruments and stepwise examinations of ocular alignment, extraocular muscle function, and deviation angle. It is limited by low diagnostic objectivity, poor pediatric compliance, and high cost. Here, we propose a strategy for one-stop strabismus digital diagnosis via artificial intelligence (AI)-integrated, skin-like, and wearable "Eyelectronics." The ultralightweight, imperceptible eye-wearable system features an ultrathin (~60 micrometers in thickness), breathable, and multidirectional (0°/45°/90°) strain-sensing array conformally adapted to the sensitive eyelid. It enables wireless, mild-restricted measurement of eyelid deformation during eye movements. Through biomechanical modeling validated by ocular magnetic resonance imaging simulations, we establish a prior correlation between eyelid deformation and eye movements. The Eyelectronics, powered by our physiology knowledge-driven end-to-end AI algorithm, achieves simultaneous measurement of strabismus angle and identification of paretic muscle. It delivers a 96.6% four-direction classification accuracy and a 1.2° measurement accuracy in ocular motility examinations. Clinical benchmarking against the clinical standard (Hess screen test) confirmed diagnostic agreement (intraclass correlation = 0.978). This system bridges quantitative biomechanical sensing with digital diagnosis, promoting a paradigm for future strabismus treatment.
