Strabismus Measurements with Novel Video Goggles

Konrad P Weber; Daniel Rappoport; Muriel Dysli; Tanja Schmückle Meier; Guy B Marks; Christopher J Bockisch; Klara Landau; Hamish G MacDougall

doi:10.1016/j.ophtha.2017.06.020

Strabismus Measurements with Novel Video Goggles

Ophthalmology. 2017 Dec;124(12):1849-1856. doi: 10.1016/j.ophtha.2017.06.020. Epub 2017 Jul 17.

Authors

Konrad P Weber¹, Daniel Rappoport², Muriel Dysli³, Tanja Schmückle Meier², Guy B Marks⁴, Christopher J Bockisch⁵, Klara Landau², Hamish G MacDougall⁶

Affiliations

¹ Department of Ophthalmology, University Hospital Zurich, University of Zurich, Switzerland; Department of Neurology, University Hospital Zurich, University of Zurich, Switzerland. Electronic address: konrad.weber@usz.ch.
² Department of Ophthalmology, University Hospital Zurich, University of Zurich, Switzerland.
³ Department of Ophthalmology, University Hospital Zurich, University of Zurich, Switzerland; Department of Neurology, University Hospital Zurich, University of Zurich, Switzerland.
⁴ Woolcock Institute of Medical Research, Sydney, Australia.
⁵ Department of Ophthalmology, University Hospital Zurich, University of Zurich, Switzerland; Department of Neurology, University Hospital Zurich, University of Zurich, Switzerland; Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Zurich, University of Zurich, Switzerland.
⁶ Vestibular Research Laboratory, School of Psychology, University of Sydney, Sydney, Australia.

PMID: 28728924
DOI: 10.1016/j.ophtha.2017.06.020

Abstract

Purpose: To assess the validity of a novel, simplified, noninvasive test for strabismus using video goggles.

Design: Cross-sectional method comparison study in which the new test, the strabismus video goggles, is compared with the existing reference standard, the Hess screen test.

Participants: We studied 41 adult and child patients aged ≥6 years with ocular misalignment owing to congenital or acquired paralytic or comitant strabismus and 17 healthy volunteers.

Methods: All participants were tested with binocular infrared video goggles with built-in laser target projection and liquid crystal display shutters for alternate occlusion of the eyes and the conventional Hess screen test. In both tests, ocular deviations were measured on a 9-point target grid located at 0±15° horizontal and vertical eccentricity.

Main outcome measures: Horizontal and vertical ocular deviations at 9 different gaze positions of each eye were measured by the strabismus video goggles and the Hess screen test. Agreement was quantified as the intraclass correlation coefficient. Secondary outcomes were the utility of the goggles in patients with visual suppression and in children.

Results: There was good agreement between the strabismus video goggles and the Hess screen test in the measurements of horizontal and vertical deviation (intraclass correlation coefficient horizontal 0.83, 95% confidence interval [0.77, 0.88], vertical 0.76, 95% confidence interval [0.68, 0.82]). Both methods reproduced the characteristic strabismus patterns in the 9-point grid. In contrast to Hess screen testing, strabismus video goggle measurements were even possible in patients with comitant strabismus and visual suppression.

Conclusions: The new device is simple and is fast and accurate in measuring ocular deviations, and the results are closely correlated with those obtained using the conventional Hess screen test. It can even be used in patients with visual suppression who are not suitable for the Hess screen test. The device can be applied in children as young as 6 years of age.

Trial registration: ClinicalTrials.gov NCT02228070.

Publication types

Comparative Study
Validation Study

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Child
Cross-Sectional Studies
Female
Healthy Volunteers
Humans
Male
Middle Aged
Oculomotor Muscles / pathology*
Signal Processing, Computer-Assisted / instrumentation*
Strabismus / diagnosis*
Vision Tests / instrumentation*
Visual Field Tests

Associated data

ClinicalTrials.gov/NCT02228070