Conventional Versus Virtual Reality-Based Hess-Lancaster Assessment: Agreement and Repeatability in Ocular Motility...

Area of Science:

• Ophthalmology
• Vision Science
• Medical Technology

Background:

• The conventional Hess-Lancaster test is a standard for assessing ocular misalignment but relies on subjective input and manual data collection.
• Virtual reality (VR) offers a potential for a more objective and standardized approach to ocular motility assessment.

Purpose of the Study:

• To compare the agreement and repeatability of ocular deviation measurements between a conventional Hess-Lancaster test and a novel VR-based implementation.
• To evaluate the Dicopt Pro VR system for ocular motility diagnostics.

Main Methods:

• A cross-sectional observational study involving 52 adults with ocular motility disorders.
• Participants completed both conventional and VR-based Hess-Lancaster assessments at predefined gaze positions.
• Statistical analyses included Bland-Altman analysis, concordance correlation coefficients, and intraclass correlation coefficients for agreement and repeatability.

Main Results:

• The VR Hess-Lancaster test demonstrated moderate agreement (concordance correlation coefficient of 0.57) with the conventional test.
• Mean bias was minimal (1.22 PD right eye, 0.10 PD left eye).
• Repeatability estimates were moderate to good (ICC 0.62–0.83), though based on a subset of participants.

Conclusions:

• The VR-based Hess-Lancaster assessment is a viable alternative, showing good agreement and repeatability compared to the conventional method.
• Findings suggest VR can provide a standardized framework for ocular motility assessment.
• Both methods require interpretation within the broader clinical context.