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Preliminary data on a novel smart glasses system for measuring the angle of deviation in strabismus

Eye volume 37, pages 2700–2706 (2023)Cite this article

Subjects

Abstract

Background/Objectives

To propose a novel smart glasses device for recording eye movement and compare its results to the prism alternate cover test (PACT).

Subjects/Methods

This method comparison study enrolled patients with strabismic conditions, who first underwent conventional strabismus evaluations (PACT in the primary position), followed by the smart glasses NeuroSpeed system (NSS) recording protocols. The video recordings were analysed using specialized software, to calculate the horizontal deviation from the primary position. The results were compared with those of the PACT using Passing‒Bablok regression and Bland‒Altman analysis.

Results

This study included 70 individuals aged 4 to 80 years, of which 38 were men and 32 were women. The overall analysis of horizontal deviations using the Passing‒Bablok regression revealed a correlation coefficient (r) of 0.969, with a systemic bias of 0.00, a proportional bias of 0.809, and a perpendicular residual standard deviation of 4.134.

Conclusions

The predictive values of eye movement examinations recorded by the NSS were comparable to those of the PACT. Thus, this new system can provide additional information for ophthalmologists to aid in the diagnosis and measurement of strabismus.

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Fig. 1: The NeuroSpeed system (NSS) recording protocol.
Fig. 2: Method comparison study between the prism alternate cover test (PACT) and the NeuroSpeed system (NSS)-based results.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Li JPO, Liu H, Ting DSJ, Jeon S, Chan RVP, Kim JE, et al. Digital technology, tele-medicine and artificial intelligence in ophthalmology: a global perspective. Vol. 82, Progress in Retinal and Eye Research. Elsevier Ltd; 2021.

  2. Kim SE, Logeswaran A, Kang S, Stanojcic N, Wickham L, Thomas P, et al. Digital Transformation in Ophthalmic Clinical Care during the COVID-19 Pandemic. Vol. 10, Asia-Pacific Journal of Ophthalmology. Lippincott Williams and Wilkins; 2021. p. 381–7.

  3. de Jongh E, Leach C, Tjon-Fo-Sang MJ, Bjerre A. Inter-examiner variability and agreement of the alternate prism cover test (APCT) measurements of strabismus performed by 4 examiners. Strabismus. 2014;22:158–66.

    Article  PubMed  Google Scholar 

  4. Holmes JM, Chandler DL, Christiansen SP, Birch EE, Bothun E, Laby D, et al. Interobserver reliability of the prism and alternate cover test in children with esotropia. Arch Ophthalmol [Internet]. 2009;127:59. http://archopht.jamanetwork.com/article.aspx?doi=10.1001/archophthalmol.2008.548.

    Article  Google Scholar 

  5. Schutte S, Polling JR, van der Helm FCT, Simonsz HJ. Human error in strabismus surgery: quantification with a sensitivity analysis. Graefe’s Arch Clin Exp Ophthalmol. 2009;247:399–409.

    Article  Google Scholar 

  6. Cheng W, Lynn MH, Pundlik S, Almeida C, Luo G, Houston K. A smartphone ocular alignment measurement app in school screening for strabismus. BMC Ophthalmol. 2021;21:150.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Pundlik S, Tomasi M, Liu R, Houston K, Luo G. Development and preliminary evaluation of a smartphone app for measuring eye alignment. Transl Vis Sci Technol. 2019;8:19.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Yehezkel O, Belkin M, Wygnanski-Jaffe T. Automated diagnosis and measurement of strabismus in children. Am J Ophthalmol. 2020;213:226–34.

    Article  PubMed  Google Scholar 

  9. Yeh PH, Liu CH, Sun MH, Chi SC, Hwang YS. To measure the amount of ocular deviation in strabismus patients with an eye-tracking virtual reality headset. BMC Ophthalmol. 2021;21:246.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Mao K, Yang Y, Guo C, Zhu Y, Chen C, Chen J, et al. An artificial intelligence platform for the diagnosis and surgical planning of strabismus using corneal light-reflection photos. Ann Transl Med. 2021;9:374–74.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Phanphruk W, Liu Y, Morley K, Gavin J, Shah AS, Hunter DG. Validation of strabis PIX, a mobile application for home measurement of ocular alignment. Transl Vis Sci Technol. 2019;8:9.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Valente TLA, de Almeida JDS, Silva AC, Teixeira JAM, Gattass M. Automatic diagnosis of strabismus in digital videos through cover test. Comput Methods Prog Biomed [Internet]. 2017;140:295–305. https://doi.org/10.1016/j.cmpb.2017.01.002.

    Article  Google Scholar 

  13. Weber KP, Rappoport D, Dysli M, Schmückle Meier T, Marks GB, Bockisch CJ, et al. Strabismus measurements with novel video goggles. Ophthalmol [Internet]. 2017;124:1849–56. https://doi.org/10.1016/j.ophtha.2017.06.020.

    Article  Google Scholar 

  14. Chen ZH, Fu H, Lo WL, Chi Z, Xu B. Eye-tracking-aided digital system for strabismus diagnosis. Health Technol Lett. 2018;5:1–6.

    Article  Google Scholar 

  15. Chen Z, Fu H, Lo WL, Chi Z. Eye-tracking aided digital system for strabismus diagnosis. Proc - 2015 IEEE Int Conf Syst Man Cybern SMC. 2015;2016:2305–9.

    Article  Google Scholar 

  16. Miao Y, Jeon JY, Park G, Park SW, Heo H. Virtual reality-based measurement of ocular deviation in strabismus. Comput Methods Prog Biomed. 2020;185:105132.

    Article  Google Scholar 

  17. Yang HK, Seo JM, Hwang JM, Kim KG. Automated analysis of binocular alignment using an infrared camera and selective wavelength filter. Invest Ophthalmol Vis Sci. 2013;54:2733–7.

    Article  PubMed  Google Scholar 

  18. von Noorden GK, Campos EC (Emilio C). Binocular vision and ocular motility: theory and management of strabismus. Mosby; 2002. p. 653.

  19. Roper-Hall G. The Hess Screen Test. Am Orthoptic J. [Internet] 2006;56:166–74. https://www.tandfonline.com/doi/full/10.3368/aoj.56.1.166.

  20. Lancaster WB. Detecting, measuring, plotting and interpreting ocular deviations. Arch Ophthalmol [Internet]. 1939;22:867–80. http://archopht.jamanetwork.com/article.aspx?articleid=614661.

    Article  Google Scholar 

  21. Christoff A, David COT, Guyton L. The lancaster red-green test. Am Orthopt J. 2006;56:157–65.

    Article  PubMed  Google Scholar 

  22. Watts P, Nayak H, Lim MK, Ashcroft A, al Madfai H, Palmer H. Validity and ease of use of a computerized Hess chart. J AAPOS. 2011;15:451–4.

    Article  PubMed  Google Scholar 

  23. Bergamin O, Zee DS, Roberts DC, Landau K, Lasker AG, Straumann D. Three-dimensional Hess screen test with binocular dual search coils in a three-field magnetic system. Invest Ophthalmol Vis Sci [Internet]. 2001;42:660–7. http://www.ncbi.nlm.nih.gov/pubmed/11222524.

    CAS  PubMed  Google Scholar 

  24. Roodhooft JM. Screen tests used to map out ocular deviations. Bull Soc Belg Ophtalmol [Internet]. 2007;305:57–67. http://www.ncbi.nlm.nih.gov/pubmed/18018429.

    Google Scholar 

  25. Holmes JM, Leske DA, Hohberger GG. Defining real change in prism-cover test measurements. Am J Ophthalmol. 2008;145:381–5.

    Article  PubMed  Google Scholar 

  26. Hatt SR, Leske DA, Liebermann L, Mohney BG, Holmes JM. Variability of angle of deviation measurements in children with intermittent exotropia. J AAPOS. 2012;16:120–4.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Neveu P, Priot AE, Plantier J, Roumes C. Short exposure to telestereoscope affects the oculomotor system. Ophthalmic Physiol Opt. 2010;30:806–15.

    Article  PubMed  Google Scholar 

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Acknowledgements

We wish to thank the research team of Neurobit Technologies Co., Ltd (Chun-Chen Yang, Wei-Cheng Chen, Chin-Hsun Huang, and Ching-Fu Wang) for the development of the NeuroSpeed system (Ophthalmic version).

Funding

This research was funded by the MOST (Ministry of Science and Technology) (MOST 110-2314-B-016-051 and MOST 111-2314-B-016-035), TSGH (Tri-Service General Hospital) (TSGH-D-109190 and TSGH-D-110111) and Ministry of National Defense Medical Affairs Bureau (MND-MAB-C-11105-111019 and MND-MAB-C14-112057).

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Author notes

  1. These authors contributed equally: Lung-Chi Lee, Kathy Ming Feng.

Authors and Affiliations

  1. Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Lung-Chi Lee, Kathy Ming Feng, Pei-Chi Chuang, Yi-Hao Chen & Ke-Hung Chien

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  1. Lung-Chi Lee
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Contributions

Design of the study (KC) and conduct of the study (KC); data collection (KF, LL), data analysis (PC, LL), and interpretation of the data (KF, LL, KC); and preparation (YC), review (KC), and approval of the manuscript (KC, YC).

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Correspondence to Ke-Hung Chien.

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Lee, LC., Feng, K.M., Chuang, PC. et al. Preliminary data on a novel smart glasses system for measuring the angle of deviation in strabismus. Eye 37, 2700–2706 (2023). https://doi.org/10.1038/s41433-023-02402-5

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