Infrared photographs with a selective wavelength filter to diagnose small-angle esotropia in young children

  • Yung Ju Yoo
  • Hee Kyung Yang
  • Jong-Mo Seo
  • Kwang Gi Kim
  • Jeong-Min HwangEmail author



To validate the effectiveness of the selective wavelength filter analysis with infrared photographs for diagnosing small-angle esotropia in children under age 4.


This is a retrospective, observational, case-control study. A total of 83 esotropes with an esodeviation of ≤ 16 prism diopters (PD) and 75 orthotropic controls under 4 years of age were included. Full-face infrared photographs were taken with a selective wavelength filter in front of either eye. The angles of esodeviation on photographs were measured with the three-dimensional Strabismus Photo Analyzer. The alternate prism and cover test or the Krimsky test were repeatedly performed to measure ocular alignment.


The testability of infrared photographs using selective wavelength filters in children under 4 years of age was 85.6%. The mean angle of esodeviation was 11.3 ± 4.0 PD by manual measurements and 11.5 ± 4.4 PD by the infrared photograph analysis. Manual measurements and the infrared photograph analysis showed a strong positive correlation (R = 0.815, P < 0.001). The sensitivity and specificity of the infrared photograph analysis for detecting small-angle esotropia were 95.2% and 77.9%, respectively, with a cutoff value of 4.0 PD.


The automated infrared photograph analysis was simple and effective for diagnosing small-angle esotropia in young children.


Esotropia Image analysis Selective wavelength filter Alignment 



This research was supported by the SNUBH research fund (No. 02-2016-051).

Compliance with ethical standards

Competing interests

The authors declare that they have no conflict of interest.

Ethics approval

Ethics approval was provided by the Institutional Review Board of Seoul National University Bundang Hospital. All aspects of the research protocol were in compliance with the Declarations of Helsinki.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of OphthalmologyKangwon National University Hospital, Kangwon National University Graduate School of MedicineChuncheonSouth Korea
  2. 2.Department of OphthalmologySeoul National University Bundang Hospital, Seoul National University College of MedicineSeongnamSouth Korea
  3. 3.Department of Electrical and Computer EngineeringSeoul National UniversitySeoulSouth Korea
  4. 4.Department of Biomedical Engineering, College of MedicineGachon UniversityInchonSouth Korea

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