The automatized measurements using a computerized program increase the measurement's repeatability by reducing the measurement errors in assessing binocular vision functions and thus improve the accuracy of diagnosing binocular vision anomalies.Ĭomputer-assisted orthoptics started in the year 1987 for both diagnosis and treatment. This is even more relevant in the current COVID-19 scenario where increased concerns about time spent in the clinics prevail. Computer orthoptics simplifies the process, brings in objectivity to the assessment, reduces the time considerably, and also could serve as a screening tool due to the increased burden of NSBVA. The conventional method of measuring fusional vergence amplitudes and accommodative facility requires trained practitioners and also involves considerable time commitment. The designed software was validated by comparing the near fusional amplitude ranges (positive and negative) and accommodative facility (monocular and binocular) with the conventional manual assessment. Upon completion, the patient is required to flip to the other side of the flipper and repeat the same procedure for 1 min. The patient would be presented with four such targets which have to be cleared out by the patient while viewing through the lenses of the accommodative flippers and a response is to be keyed into the keyboard. The vertical fusional ranges were also assessed using the same principle.įor accommodative facility, the patient would have to use the accommodative flippers and clear the targets (Landolt C) displayed on screen. Moreover, for a negative feedback, the disparity gets reduced by one step and the disparity further reduces until a positive response is keyed in. The manual and computerized assessments were carried out by masked experienced examiners.įor the vergence testing, the RDS stimulus is initially presented at a disparity of zero, and as the patient gives a positive feedback, the disparity is increased by one prism diopter (PD) steps for convergence and by 0.5 PD steps for divergence. The software is calibrated for testing at a distance of 40 cm.īefore performing the computer-based assessment, the subjects were informed as to the different targets that would be used during the assessment and the responses that are expected out of them. The oculomotor functions of Saccades and Pursuits are assessed using a Tumbling E as a target. Standard ± 2.00 DS accommodative flippers are utilized with Landolt C targets as stimulus to test for accommodative facility. It uses Random Dot Stereogram (RDS) as a stimulus for testing vergence parameters combined with red-blue anaglyph glasses. The software has been designed to execute a binocular vision assessment, in-office vision therapy, and home-based vision therapy. The indigenously developed computer-based Train Your Eyes (TrYE) software was intended to aid as a quick screening tool in the diagnosis of NSBVA. Considering the increased prevalence and need for diagnosing NSBVA, this study aimed to assess the diagnostic accuracy and efficacy of an indigenously developed computer-based orthoptic program (Train your eyes ®).Ĭomputer-based binocular vision assessment There is still paucity in the literature about the diagnostic accuracy of computer-based software compared to conventional manual binocular vision assessment. Eight various other studies have also reported a reduction of asthenopic symptoms following computer-based vision therapy. Accommodative and vergence parameters have shown clinically significant improvement with home vision therapy (HTS) program that utilizes randot stereogram utilizing an operant conditioning paradigm. The convergence insufficiency treatment trial utilized computer-based vision therapy (home therapy solutions – HTS Inc.,) programs to provide in-office and home-based vision therapy. In the recent past, the use of computers has seen a steady upsurge, increasing the accessibility to provide computer orthoptics for diagnosing and giving therapy programs. The expected findings or normative data for binocular vision and accommodative testing used in the diagnosis and classification of NSBVA also vary by ethnicity.Ĭomputer-based orthoptics or vision therapy enables the standardization of the testing and treatment protocols. Based on BAND study, the minimum battery of tests required to screen NSBVA in the community set-up included phoria for distance and near, near point of convergence with red filter, and monocular accommodative facility through manual assessment. The prevalence of NSBVA among schoolchildren in Southern India was reported to be 30.8%. Binocular vision and accommodative anomalies are termed as “Nonstrabismic Binocular Vision anomalies” (NSBVA) represent the most common visual disorder compared to refractive errors among clinical pediatric populations.
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