Advertisement

Self-assessment of angles of strabismus with photographic Purkinje I and IV reflection pattern evaluation

  • Rolf Effert
  • Jean-Cyriaque Barry
  • Roland Colberg
  • Ansgar Kaupp
  • Gabriele Scherer
Clinical Investigation

Abstract

• Background: Accurate assessment of the angle of strabismus, e.g. of variable angles of strabismus, is crucial in preoperative patient management and is usually performed in a clinical environment. Objective assessment by patients themselves, under everyday conditions, could contribute to a better preoperative work-up. A new objective evaluation procedure for the measurement of manifest angles of strabismus for near and distance fixation by the patient himself is presented. • Methods: To account for the modified experimental setup used for the self-assessment, an amended computation procedure of Purkinje reflection pattern evaluation was developed. For measurement, patients and controls placed their head on a head/chin rest and fixated at 33 cm or 4 m distance in primary position. A reflex camera and three photo flash units were positioned on a special frame underneath the visual axis and in front of the subject so that both eyes could be photographed simultaneously. The camera's remote shutter control was released together with the photo flash units by the properly fixating subject. The angles of strabismus were obtained from the series of pictures through later evaluation of the Purkinje I and IV reflection patterns recorded in the photographs of the eyes.

• Results: Measurements of the ocular alignment in two control groups and in a group of strabismic subjects showed satisfactory accuracy of the “self-assessment” method compared to “standard” Purkinje reflection pattern evaluation and orthoptic measurements of the angle of strabismus.

• Conclusion: The modified “self-assessment” method can be used for the objective recording of angles of strabismus as needed in the preoperative work-up of patients with variable angles of strabismus, over prolonged periods of time, and outside a clinical setting.

Keywords

Objective Evaluation Variable Angle Strabismus Clinical Environment Distance Fixation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Barry JC, Effert R, Kaupp A (1992) Objective measurement of small angles of strabismus in infants and children with photographic Purkinje reflection pattern evaluation. Ophthalmology 99:320–328Google Scholar
  2. 2.
    Barry JC, Effert R, Kaupp A, Burhoff A (1994) Assessment of ocular alignment with Purkinje I and IV reflection pattern evaluation. Invest Ophthalmol Vis Sci 35 (13):4219–4230Google Scholar
  3. 3.
    Barry JC, Effert R, Kaupp A, Kleine M, Reim M (1994) Computergestützte Messung von Augenfehlstellungen bei Säuglingen und Kleinkindern mit Hilfe des digitalen Purkinje Reflexmusterverfahrens. Ophthalmologe 91:51–61Google Scholar
  4. 4.
    Barry JC, Effert R, Reim M, Meyer-Ebrecht D (1994) Computational principles in Purkinje I and IV reflection pattern evaluation for the assessment of ocular alignment. Invest Ophthalmol Vis Sci 35 (13):4205–4218Google Scholar
  5. 5.
    Bennett AG, Rabbetts RB (1989) Clinical visual optics, 2nd edn. Butterworths, LondonGoogle Scholar
  6. 6.
    Carpenter RHS (1989) Movements of the eyes. Pion, LondonGoogle Scholar
  7. 7.
    Clement RA, Dunne MCM, Barnes DA (1987) A method for raytracing through schematic eyes with off-axis components. Ophthalmic Physiol Opt 7:149–152Google Scholar
  8. 8.
    Effert R (1986) A new method for determining squint angle in primary and all secondary positions using the first and fourth Purkinje images. Ophthalmology 93:436–441Google Scholar
  9. 9.
    Effert R, Barry JC, Dahm M, Kaupp A (1991) Eine neue photographische Methode zur Messung von Schielwinkeln bei Säuglingen und kleinen Kindern. Klin Monatsbl Augenheilkd 198:284–289Google Scholar
  10. 10.
    Effert R, Barry JC, Kaupp A, Kleine M (1992) New methods for the assessment of eye deviations in strabismus. Chibr Int J Ophthalmol 9:49–61Google Scholar
  11. 11.
    Lang J (1984) The fourth image of Purkinje: a diagnostic tool in microtropia. Doc Ophthalmol 58:91–95Google Scholar
  12. 12.
    Noorden GK von (1990) Binocular vision and ocular motility, 4th edn. Mosby, St. LouisGoogle Scholar

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • Rolf Effert
    • 1
  • Jean-Cyriaque Barry
    • 2
  • Roland Colberg
    • 2
  • Ansgar Kaupp
    • 3
  • Gabriele Scherer
    • 2
  1. 1.Department of OphthalmologyEssen University HospitalGermany
  2. 2.Department of OphthalmologyRWTH Aachen University HospitalAachenGermany
  3. 3.Lehrstuhl für Meßtechnik, Faculty of Electrical EngineeringRWTH Aachen UniversityGermany

Personalised recommendations