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Determining vertical fusion values from digital photographs of healthy eyes

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Abstract

Purpose

To determine the mean difference of vertical corneal light reflex (VCLR) among healthy eyes via digital photography.

Study Design

Retrospective study.

Methods

The study enrolled 155, healthy eyes participants, 71 males and 84 females with a mean age of 14.7 years (range 12–19 years). The participants received complete eye examinations and 2 digital photographs were taken, with the flash on, while participants fixated their eyes on a near and a distant target. Two hundred and eighty qualified photographs were analyzed by Photo-Hirschberg testing using computer software. The vertical corneal light reflex ratio (VCLRR) was calculated as the distance of the corneal light reflex (CLR) to the inferior limbus or to the pupillary border divided by the horizontal corneal diameter, defined as VCLRR1 or VCLRR2. VCLRR was analyzed using Spearman’s correlation.

Results

The mean ± SD of horizontal corneal diameter in near and distance photographs was 11.47 ± 0.62 and 11.37 ± 0.58 mm, respectively. For correlation analysis, at 1 m fixation and 6 m fixation, the number of participants within an acceptable range of vertical fusion were 94.6% and 100% of participants. The 95th percentiles (estimated as the mean ± 1.64SD) in VCLRR1 between the two eyes at near and at distance fixation were 0.0316 and 0.0272, respectively; whereas the corresponding values for VCLRR2 were 0.0309 and 0.0240, respectively.

Conclusions

The normal range of the vertical corneal light reflex ratio suggests that the Photo-Hirschberg test could be used for screening vertical strabismus cases depending on iris pigment.

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Acknowledgements

We would like to thank many individuals; including, Dr. Alan Geater for his suggestions and Ms. Somporn Bhurachokwiwat, Ms. Srirabay Chouyjan and Ms. Parichat Damthongsuk for their assistance in data collection and statistical analysis. Additionally, we want to thank Mr. Geoffrey Cox and Mr. Athanasios Maniatis, from our International Affairs department, for assistance in proofreading this paper.

Funding

No funding was received for this research.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand

    Supaporn Tengtrisorn & Kornkamon Sertsom

  2. Department of Ophthalmology, Faculty of Medicine, Naresuan University, Phisanulok, Thailand

    Mayuree Montriwet

  3. Department of Ophthalmology, Chiangmai Ram Hospital, Muang, Chiang mai, Thailand

    Kornkamon Sertsom

Authors
  1. Supaporn Tengtrisorn
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  2. Mayuree Montriwet
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  3. Kornkamon Sertsom
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Corresponding author

Correspondence to Supaporn Tengtrisorn.

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Conflict of interest

The authors have not disclosed any competing interests.

Ethical standard

All procedures performed in this study, which involved human participants, were in accordance with the ethical standards of the Ethics Committee of the Faculty of Medicine, Prince of Songkla University. REC number: 58–307-02–3, Thai legislation and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study is retrospective and the Ethics Committee of the Faculty of Medicine, Prince of Songkla University, REC number: 58–307-02–3; waived informed consent requirements. Nevertheless, the participants have given informed consent in connection to the original procedures that were undertaken, but no informed consent is in place in regard to sharing any personally identifying data such as photographs of their faces.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Tengtrisorn, S., Montriwet, M. & Sertsom, K. Determining vertical fusion values from digital photographs of healthy eyes. Int Ophthalmol 42, 3849–3856 (2022). https://doi.org/10.1007/s10792-022-02405-3

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  • DOI: https://doi.org/10.1007/s10792-022-02405-3

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