A VR-based Automated Strabismus Diagnosis System with Progressive Semi-Supervised Learning

Strabismus is a prevalent ocular disorder that can impair visual development and cause psychological issues if not diagnosed early. Conventional clinical diagnosis primarily relies on the prism cover test (PCT), which is subjective, requires patient cooperation, and lacks standardization. Recent advances in virtual reality (VR) and deep learning offer promising solutions for automated and standardized diagnosis. However, practical deployment faces three key challenges: realistic VR simulation of clinical exams, addressing image degradation (reflections/occlusions) with limited annotated data, and precise quantification of ocular deviations. In this study, we propose a novel VR-based automated strabismus diagnosis system by leveraging semi-supervised deep learning, and introduce a new clinical dataset, TongRenD. The framework incorporates five standardized clinical examination scenarios within a VR environment to ensure diagnostic consistency. We introduce ProgNet: an uncertainty-guided progressive semi-supervised segmentation network that integrates a Prototype-based Feature Representation Module (PFRM) to enhance robustness against visual noise and distortions under limited annotations. A dedicated 3D deviation estimation algorithm further enables accurate strabismus classification and angular measurement. Extensive experiments on the TongRenD and TEyeD datasets demonstrate that ProgNet outperforms state-of-the-art methods in segmentation accuracy. Clinical validation confirms that our system achieves high consistency with expert assessments, providing a standardized, non-invasive, and reliable solution for strabismus diagnosis.