ArticleBMC ophthalmology2021
A smartphone ocular alignment measurement app in school screening for strabismus.
Article in BMC ophthalmology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 4 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 4 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Systematic review and meta-analysis of artificial intelligence models for strabismus screening: methodological insights and future directions.International journal of surgery (London, England) · 2025Pooled it
- Investigating Primary School Nurses' Activities That Are Effective in Health Promotion and Primary Prevention: A Systematic Review.The Journal of school health · 2025Pooled it
- Automated strabismus evaluation: a critical review and meta-analysis.Frontiers in neurology · 2025Pooled it
- Home-based screening tools for amblyopia: a systematic review.Eye (London, England) · 2023Pooled it
- Squint ASSIST: A Novel Application Program for Detecting Strabismus and Measuring Angle of Deviation.Clinical ophthalmology (Auckland, N.Z.) · 2026Article
- Quantitative Assessment of Strabismus Using Cloud AI Computing: Validation Study.JMIR formative research · 2025Article
- High-Accuracy Intermittent Strabismus Screening via Wearable Eye-Tracking and AI-Enhanced Ocular Feature Analysis.Biosensors · 2025Article
- Pilot Study Comparing the Ocular Deviation Measures of Basic Intermittent Exotropia Using 2WIN-S and Prism Cover Test.The British and Irish orthoptic journal · 2025Article
- Evaluation of a Novel Virtual Reality Simulated Alternate Cover Test to Assess Strabismus: A Prospective, Masked Study.American journal of ophthalmology · 2025Article
- An artificial intelligence platform for the screening and managing of strabismus.Eye (London, England) · 2024Article
- Subjective Refraction Test Using a Smartphone for Vision Screening.Journal of visualized experiments : JoVE · 2024Article
- Usefulness Assessment of Automated Strabismus Angle Measurements Using Innovative Strabiscan Device.Journal of clinical medicine · 2024Article
- Apple Vision Pro for Ophthalmology and Medicine.Annals of biomedical engineering · 2023Article
- Preliminary data on a novel smart glasses system for measuring the angle of deviation in strabismus.Eye (London, England) · 2023Article
- Evaluation of Endo 10 mobile application as diagnostic tool in endodontics.Journal of clinical and experimental dentistry · 2023Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundStrabismus is the leading risk factor for amblyopia, which should be early detected for minimized visual impairment. However, traditional school screening for strabismus can be challenged due to several factors, most notably training, mobility and cost. The purpose of our study is to evaluate the feasibility of using a smartphone application in school vision screening for detection of strabismus.
methodsThe beta smartphone application, EyeTurn, can measure ocular misalignment by computerized Hirschberg test. The application was used by a school nurse in a routine vision screening for 133 elementary school children. All app measurements were reviewed by an ophthalmologist to assess the rate of successful measurement and were flagged for in-person verification with prism alternating cover test (PACT) using a 2.4Δ threshold (root mean squared error of the app). A receiver operating characteristic (ROC) curve was used to determine the best sensitivity and specificity for an 8Δ threshold (recommended by AAPOS) with the PACT measurement as ground truth.
resultsThe nurse obtained at least one successful app measurement for 93% of children (125/133). 40 were flagged for PACT, of which 6 were confirmed to have strabismus, including 4 exotropia (10△, 10△, 14△ and 18△), 1 constant esotropia (25△) and 1 accommodative esotropia (14△). Based on the ROC curve, the optimum threshold for the app to detect strabismus was determined to be 3.0△, with the best sensitivity (83.0%), specificity (76.5%). With this threshold the app would have missed one child with accommodative esotriopia, whereas conventional screening missed 3 cases of intermittent extropia.
conclusionsResults support feasibility of use of the app by personnel without professional training in routine school screenings to improve detection of strabismus.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.