Abstract
To compare the angle of deviation measured from Photo-Hirschberg testing and Krimsky testing, with that from an alternate prism cover test (APCT) in strabismus patients. A cross-sectional study was conducted in Songklanagarind Hospital, Thailand. Thirty-three strabismus patients were photographed for analysis by Photo-Hirschberg testing using computer software. The corneal light reflex displacement, converted into prism diopter (PD), was compared to the angle of deviation measured with APCT. Twenty-eight strabismus patients were tested with the Krimsky test. Data were analyzed using Pearson correlation and paired t-tests. The study excluded 4 intermittent exotropia cases, 1 intermittent esotropia case and 2 which cases missing data for krimsky test. The mean±SD of the deviation angle, measured by APCT with a fixation target at 30 cm and 6 m; were 48.09±16.34PD and 47.82±15.73 PD, respectively. At 1 m, the difference in the angle of deviation measured from APCT and the Photo-Hirschberg test within 10 PD were 58.8% and 63.6%, for ET and XT, respectively. The difference in the angle of deviation measured from APCT and Krimsky tests within 10 PD in ET and XT were 86.7% and 80.0%, respectively. At 4 m, the difference in angle of deviation measured from APCT and Photo-Hirschberg tests within 10 PD in ET and XT were 58.8% and 54.5%, respectively; whereas, the difference in the angle of deviation measured from APCT and Krimsky tests within 10 PD in ET and XT were 80.0% and 70.0%, respectively. The reliability of Krimsky test was better than Photo-Hirschberg test for measuring an angle of deviation.
Highlights
There are various methods for diagnosis of strabismus and measuring the angle of deviation
The corneal light reflex displacement, converted into prism diopter (PD), was compared to the angle of deviation measured with alternate prism cover test (APCT)
At 1 m, the difference in the angle of deviation measured from APCT and the Photo-Hirschberg test within 10 PD were 58.8% and 63.6%, for ET and XT, respectively
Summary
There are various methods for diagnosis of strabismus and measuring the angle of deviation. The alternate prism cover test (APCT) is the gold standard method. This method requires professionalism, is time consuming, depends on a special device) prism(, and requires the cooperation of patients in the measurement. Cost effective and accurate alternative methods involving simple procedures that can be performed in hospitals within rural areas are required. This study looks at a simple method that uses affordable equipment to reduce that workload. This method could help reduce the travel burden for patients in rural settings for access to a tertiary care hospital. It is expected that the results will provide accurate measurement of the angle of deviation; in cases of uncooperative patients
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