October 1993
Volume 34, Issue 11
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Articles  |   October 1993
Videographic Hirschberg measurement of simulated strabismic deviations.
Author Affiliations
  • J M Miller
    Department of Ophthalmology, University of Arizona, Tucson.
  • M Mellinger
    Department of Ophthalmology, University of Arizona, Tucson.
  • J Greivenkemp
    Department of Ophthalmology, University of Arizona, Tucson.
  • K Simons
    Department of Ophthalmology, University of Arizona, Tucson.
Investigative Ophthalmology & Visual Science October 1993, Vol.34, 3220-3229. doi:
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    • Get Citation

      J M Miller, M Mellinger, J Greivenkemp, K Simons; Videographic Hirschberg measurement of simulated strabismic deviations.. Invest. Ophthalmol. Vis. Sci. 1993;34(11):3220-3229.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

PURPOSE: To demonstrate the potential use of subpixel image processing methods to perform automated Hirschberg measurements of strabismic deviations using relatively inexpensive personal computer hardware; to determine if the method might allow screening for strabismus using full-face video images obtained from a distance of 1 meter. METHODS: Strabismic deviations (< 25 prism diopters) were simulated by means of induced asymmetric fixation. A ring of coaxial infrared light-emitting diodes (LED) were used to generate first Purkinje reflexes. Computerized image analysis with subpixel processing was used to measure the locations of the first Purkinje reflexes and pupil centers of video images of 10 normal subjects, following the technique of the clinical Hirschberg test. The apparent strabismic deviation was calculated from the relative asymmetry of the center of the corneal reflex ring to the pupil center in each eye. RESULTS: In 10 normal subjects, there was a statistically significant linear correlation of Hirschberg horizontal reflex deviation with asymmetric fixation pseudo-esotropia (0.85 > or = r2 > or = 0.99, P < 0.05). CONCLUSIONS: The Hirschberg test is used manually to detect strabismus in infants and children but requires a highly skilled examiner. The image processing method described here requires no operator interpretation and may make the test more applicable. The results suggest that this technology may be appropriate for a screening instrument.

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