Clinical ophthalmology
Squint ASSIST: A Novel Application Program for Detecting Strabismus and Measuring Angle of Deviation
By Srisaenpang N, Homdee N, Yospaiboon Y and 1 others.
Abstract
Purpose
To develop and validate Squint ASSIST (Squint Automatic Strabismus Sizing using Image Sensing Technology), an application program for strabismus detection and angle measurement, using corneal light reflex deviation in eye photographs.
Methods
This prospective cross‑sectional clinic‑based study enrolled 136 patients and 1384 photographs. Two analytic methods were evaluated: Method 1 (inter-ocular comparison; comparing corneal light reflex positions between both eyes in one image) and Method 2 (intra‑ocular comparison; comparing the same eye in a straight vs deviated image). Photographs were processed with standardized processing images. The participants' angles of deviation were measured using this program, which converts the light reflex deviation to misaligned angles in prism diopters. The main outcome was the sensitivity, specificity, and accuracy of the program for detecting strabismus. The agreement between the angles measured by the program and those measured by pediatric ophthalmologists using the Krimsky test and the Alternate Prism Cover Test (APCT) was analyzed using the Bland-Altman plot. Intra-observer and inter-observer reproducibility were also evaluated.
