A Low-Complexity and Efficient VR-Based System with Infrared Image Processing for Assessing the Angle of Ocular Misalignment in Strabismus Patients

Strabismus , an ophthalmic condition affecting approximately 2% to 5% of the global population and with a pediatric prevalence rate of about 2% to 4%, can lead to binocular vision impairment and eventual vision loss if left uncorrected for an extended period. Early detection and correction of ocular deviations are crucial in mitigating these risks. However, primary clinical tests like the prism cover test (PCT) and the Hirschberg test (HT) have limitations. These tests rely on operator skills for an accurate measurement. Moreover, the PCT demands sustained patient focus throughout prolonged testing. In our study, we developed a simplified and efficient VR-based system with infrared image processing to evaluate the angle of ocular deviation in strabismus patients. This system utilizes an automated assessment method to effectively imitate the alternate cover test, a traditional procedure for strabismus assessment. The results showed no significant differences in measurements of ocular misalignment between our VR-based system and the doctor's test among the strabismus patients. Consequently, this system prototype offers noninvasive assessment, rapid detection, and ease of operation, making it a potentially efficient alternative for the clinical screening of strabismus.