Comparison of Methods for Measuring Cyclodeviation

Liebermann, Laura; Hatt, Sarah R.; Klaehn, Lindsay D.; Kramer, Andrea; Holmes, Jonathan M.

doi:10.1016/j.ajo.2020.11.005

Cited by 7 publications

(4 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although there have been efforts to extract cyclodeviation from fundus images (15,16), sensory measurements using DMR remain the gold standard, comparable with synoptophore measurements which require a bulky desktop device (4). Sensory techniques have previously been used to obtain cyclodeviation measurements using a desktop display (16) or smartphone app (14) coupled with red/green glasses to isolate the inputs to each eye.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Development and Preliminary Validation of a Virtual Reality Approach for Measurement of Torsional Strabismus

Bindiganavale¹,

Buickians²,

Lambert³

et al. 2021

Journal of Neuro-Ophthalmology

View full text Add to dashboard Cite

Background:Double Maddox rod (DMR), the gold-standard method for in-office measurement of cyclodeviation, requires an examiner and specialized equipment. The objective of this study was to develop a virtual reality (VR) technique for measurement of cyclodeviation and validate this against the DMR.Methods:A VR-DMR was implemented using a smartphone and commercially available VR viewer. The app displayed a line to each eye and accepted touch inputs from the user to rotate the lines into perceived alignment. VR-DMR cyclodeviation measurements were compared with traditional DMR (T-DMR) cyclodeviation measurements in adults with and without strabismus and children without strabismus.Results:Thirty-one subjects were studied (age 5–88 years, 20 with strabismus). VR-DMR had similar test–retest reliability as T-DMR. VR-DMR was highly correlated with T-DMR (r2 = 0.94, linear regression slope 1.12) with a slight positive bias (linear regression y intercept 1°). VR-DMR was preferred by 54% of subjects with 29% having no preference.Conclusions:A VR method of ocular cyclodeviation measurement using sensory techniques was implemented using commercially available hardware. VR measurements compared favorably with gold-standard DMR measurements, and user feedback was positive. The VR methodology has application for in office and home use by nonexperts for purposes of strabismus monitoring.

show abstract

Section: Discussionmentioning

confidence: 99%

“…It is performed by placing lenses that refract a point light source into a line image in front of each eye. The patient is asked to rotate the lenses, so the lines are perceived to be parallel to each other (4). Measurements are imprecise and prone to administrator error (5).…”

Section: Introductionmentioning

confidence: 99%

Development and Preliminary Validation of a Virtual Reality Approach for Measurement of Torsional Strabismus

Bindiganavale¹,

Buickians²,

Lambert³

et al. 2021

Journal of Neuro-Ophthalmology

View full text Add to dashboard Cite

show abstract

“…Objective deviations were evaluated (to test whether the patient was able to fuse at the objective angle) using a traditional synoptophore (Oculus, Wetzlar, Germany), and a modern version based on virtual reality glasses with an eye tracker (VisionaryVR; VisionaryTool S.L., Gijón, Spain). Deviations in cyclotorsion were measured with both synoptophore devices in addition to a Double Maddox rod test ( Liebermann et al, 2021 ).…”

Section: Methodsmentioning

confidence: 99%

Successful treatment of diplopia using prism correction combined with vision therapy/orthoptics improves health-related quality of life

Portela-Camino,

Sanchez,

Gutierrez

et al. 2024

PeerJ

View full text Add to dashboard Cite

Background To track improvement in diplopia symptoms with strabismus-specific health-related quality of life (HRQOL) questionnaire across a treatment consisting of prism correction followed by vision therapy/orthoptics when prism treatment alone has not succeeded. Methods Forty-eight participants with diplopia and a mean age of 62.45 were asked to complete an Adult Strabismus-20 (AS-20) questionnaire and a Diplopia Questionnaire (DQ) before and after prism correction. Inclusion criteria were diplopia reported on the DQ as “sometimes”, “often” or “always” at reading or straight-ahead distance. The prism correction was classified as successful if the participant reported “never” or “rarely” on the DQ for reading and straight-ahead distance; and unsuccessful if the perceived diplopia worsened or remained the same. For all participants, mean initial AS-20 scores were compared with mean post-prism correction scores, taking into account AS-20 subscales (reading and general functions, and self-perception and interaction). Participants in the failed prism treatment subgroup subsequently underwent a programme of vision therapy wearing their prism correction, the results of which were again determined by participants’ responses on the AS-20 questionnaire, completed before and after the vision therapy. Results Five of the 48 participants dropped out of the study. Prism correction was classified as successful in 22 of 43 participants (51%), and unsuccessful in 21 (49%). Those participants for whom the prism correction was classified as a success showed a statistically significant improvement (p = 0.01) in both reading and general functions. In the failed treatment subgroup, no significant change in AS-20 score was recorded for any of the domains (p = 0.1). After treatment with vision therapy/orthoptics, however, 13 of the 20 participants in the unsuccessful prism correction subgroup (one of them dropped out the study) achieved binocular vision and statistically significant improvement in reading and general functions (p = 0.01). Conclusions Although effective prism correction of diplopia is correlated with enhanced HRQOL, prism correction alone is frequently not sufficient to achieve this objective. In these cases, vision therapy/orthoptics treatment as a coadjutant to prism correction is shown to improve HRQOL.

show abstract

“…The actions of the various extraocular muscles are generally not independent, and with incomitant strabismus, the direction and extent of misalignment may vary significantly with the gaze direction 5 . Measurement of eye misalignment in strabismic patients may be performed by orthoptists or optometrists using various instruments, including refracting prisms, the double Maddox rod, and the synoptophore, 6 the latter two being able to measure torsional misalignment.…”

mentioning

confidence: 99%

Wearable apparatus for correction of visual alignment under torsional strabismus

Malleson,

Guillemaut

2024

Optom Vis Sci

View full text Add to dashboard Cite

SIGNIFICANCE A wearable optical apparatus that compensates for eye misalignment (strabismus) to correct for double vision (diplopia) is proposed. In contrast to prism lenses, commonly used to compensate for horizontal and/or vertical misalignment, the proposed approach is able to compensate for any combination of horizontal, vertical, and torsional misalignment. PURPOSE If the action of the extraocular muscles is compromised (e.g., by nerve damage), a patient may lose their ability to maintain visual alignment, negatively affecting their binocular fusion and stereo depth perception capability. Torsional misalignment cannot be mitigated by standard Fresnel prism lenses. Surgical procedures intended to correct torsional misalignment may be unpredictable. A wearable device able to rectify visual alignment and restore stereo depth perception without surgical intervention could potentially be of great value to people with strabismus. METHODS We propose a novel lightweight wearable optical device for visual alignment correction. The device comprises two mirrors and a Fresnel prism, arranged in such a way that together they rotationally shift the view seen by the affected eye horizontally, vertically, and torsionally. The extent of the alignment correction on each axis can be arbitrarily adjusted according to the patient's particular misalignment characteristics. RESULTS The proposed approach was tested by computer simulation, and a prototype device was manufactured. The prototype device was tested by a strabismus patient exhibiting horizontal and torsional misalignment. In these tests, the device was found to function as intended, allowing the patient to enjoy binocular fusion and stereo depth perception while wearing the device for daily activities over a period of several months. CONCLUSIONS The proposed device is effective in correcting arbitrary horizontal, vertical, and torsional misalignment of the eyes. The results of the initial testing performed are highly encouraging. Future study is warranted to formally assess the effectiveness of the device on multiple test patients.

show abstract

Comparison of Methods for Measuring Cyclodeviation

Cited by 7 publications

References 12 publications

Development and Preliminary Validation of a Virtual Reality Approach for Measurement of Torsional Strabismus

Development and Preliminary Validation of a Virtual Reality Approach for Measurement of Torsional Strabismus

Successful treatment of diplopia using prism correction combined with vision therapy/orthoptics improves health-related quality of life

Wearable apparatus for correction of visual alignment under torsional strabismus

Contact Info

Product

Resources

About