Search research articles

ABOUT JoVE

Overview Leadership Blog JoVE Help Center

AUTHORS

Publishing Process Editorial Board Scope & Policies Peer Review FAQ Submit

LIBRARIANS

Testimonials Subscriptions Access Resources Library Advisory Board FAQ

RESEARCH

JoVE Journal Methods Collections JoVE Encyclopedia of Experiments Archive

EDUCATION

JoVE Core JoVE Business JoVE Science Education JoVE Lab Manual Faculty Resource Center Faculty Site

Terms & Conditions of Use

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by

Same author

Noninvasive Cardiac Output Monitoring Combined With Critical Care Ultrasound for Postoperative Volume Management in Cardiac Surgery Patients: A Randomized Controlled Trial.

The Journal of surgical research·2026

Same author

Uncovering the neglected feedback of accumulated polyphenol toward self-enhanced electro-polymerization.

Water research·2026

Same author

Fixation and saccadic performance throughout childhood in children born preterm: A multicenter eye-tracking study.

Pediatric research·2026

Same author

LncRNA PCGEM1 Promotes Endoplasmic Reticulum Stress in Osteosarcoma Cells Under Hypoxia by Activating JAK/STAT3 Signaling Pathway.

The Tohoku journal of experimental medicine·2026

Same author

Stabilizing Extreme Few-Shot ECG Classification via Self-Supervised Contrastive Pretraining.

Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·2026

Same author

The Impact of Ophthalmic Lens Power and Treatments on Eye Tracking Performance.

Journal of eye movement research·2026

Search research articles

Related Experiment Video

Updated: Jul 13, 2026

Using an Automated Hirschberg Test App to Evaluate Ocular Alignment

Using an Automated Hirschberg Test App to Evaluate Ocular Alignment

Published on: March 24, 2020

Development and Clinical Validation of a Digital Eye-Tracking-Based Cover Test for Ocular Misalignment.

Eduardo Esteban-Ibañez¹, David Solanas¹, Marta Lacort-Beltrán¹

¹Aragon Institute for Health Research (IIS Aragón), Zaragoza, Spain.

Ophthalmology Science

|July 12, 2026

Summary

The DIVE Cover Test (DCT), a portable digital eye-tracking tool, accurately detects ocular misalignment, showing strong agreement with the classic cover test (CCT). This innovative device offers excellent repeatability and is a practical option for clinical use.

Keywords:

Cover test Digital device Eye tracking Sensorimotor examination Strabismus

More Related Videos

Using Eye-tracking to Assess the Relative Importance of Visual and Vestibular Input to Subcortical Motion Processing in the Roll Plane

Using Eye-tracking to Assess the Relative Importance of Visual and Vestibular Input to Subcortical Motion Processing in the Roll Plane

Published on: August 22, 2025

Quantification of Oculomotor Responses and Accommodation Through Instrumentation and Analysis Toolboxes

Quantification of Oculomotor Responses and Accommodation Through Instrumentation and Analysis Toolboxes

Published on: March 3, 2023

Related Experiment Videos

Last Updated: Jul 13, 2026

Using an Automated Hirschberg Test App to Evaluate Ocular Alignment

Using an Automated Hirschberg Test App to Evaluate Ocular Alignment

Published on: March 24, 2020

Using Eye-tracking to Assess the Relative Importance of Visual and Vestibular Input to Subcortical Motion Processing in the Roll Plane

Using Eye-tracking to Assess the Relative Importance of Visual and Vestibular Input to Subcortical Motion Processing in the Roll Plane

Published on: August 22, 2025

Quantification of Oculomotor Responses and Accommodation Through Instrumentation and Analysis Toolboxes

Quantification of Oculomotor Responses and Accommodation Through Instrumentation and Analysis Toolboxes

Published on: March 3, 2023

Area of Science:

Ophthalmology and Vision Science
Medical Technology and Instrumentation
Diagnostic Accuracy Studies

Background:

The cover test is a fundamental clinical assessment for detecting ocular misalignment (strabismus).
Traditional cover tests rely on subjective observation, introducing potential variability.
There is a need for objective, portable, and accurate tools to quantify ocular deviations.

Purpose of the Study:

To develop and validate the DIVE Cover Test (DCT), a portable, eye-tracking-based digital cover test.
To assess the DCT's diagnostic accuracy, agreement with the classic cover test (CCT), and repeatability.
To evaluate performance across different cover test phases (cover-uncover test [CUT] and alternate cover test [ACT]) and ocular axes (horizontal and vertical).

Main Methods:

A prospective clinical validation study involving 68 participants (3-74 years) with and without strabismus.
Participants underwent repeated DCT and CCT examinations by experienced clinicians at near distance.
Diagnostic performance (sensitivity/specificity), intermethod agreement (Bland-Altman, ICCs, Pearson correlation), and test-retest repeatability were analyzed.

Main Results:

The DCT demonstrated high diagnostic accuracy: 85% sensitivity and 98% specificity in CUT; 92% sensitivity and 87% specificity in ACT.
Strong agreement was observed between DCT and CCT, particularly for horizontal deviations during ACT (ICC=0.96).
Excellent DCT test-retest repeatability (ICC ≥0.93) and narrow limits of agreement (±3.8 to ±4.6 PD) were achieved across all conditions.

Conclusions:

The DIVE Cover Test (DCT) is a highly accurate and repeatable tool for quantifying ocular misalignment.
It shows strong agreement with the established classic cover test (CCT), supporting its clinical utility.
The DCT offers a practical, portable, and objective alternative for strabismus evaluation in clinical settings.