An Image-Based Method for Measuring Strabismus in Virtual Reality

Strabismus is a visual disorder characterized by eye misalignment. The effect of Panum's Fusional Area (PFA) compensates for small misalignments. However, prominent misalignments affect binocular vision and when present in childhood it may lead to amblyopia, a developmental disorder of the visual system. With the advent of Virtual Reality (VR) technology, possibilities for novel binocular treatments to amblyopia arise in which the measurement of strabismus is crucial to correctly compensate for it. Thus, VR yields great potential due to the ability of displaying content to each eye independently. Major research in VR addresses this topic using eye-tracking while there is a paucity of research on image-based assessment methods. In this work, we propose a VR application for measuring strabismus in nine lines of sight. We conducted a study with 14 healthy participants to evaluate the system under two conditions: no strabismus and an artificial deviation induced by prism lenses. Further, we evaluated the effect of PFA on the system by measuring its extent in horizontal and vertical lines of sight. Results show significant difference between the expected deviation induced by prism lenses and the measured deviation. The existing difference within the measurements can be explained with the recorded extent of the PFA.