Making stereopsis related to the ability of ocular deviation: a new paradigm for assessment of intermittent exotropia
Authors:   State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510623, Guangdong Province, China; Department of Ophthalmology, the Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China, Li Jian-Bing , Shen Tao ,   State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510623, Guangdong Province, China, Yuan Yong-Guang ,   State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510623, Guangdong Province, China, Chen Chong-Lin ,   State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510623, Guangdong Province, China, Peng Dan-Min ,   Guangzhou Xinhua University, Guangzhou 510520, Guangdong Province, China, Liang Min-Tong ,   Guangzhou Xinhua University, Guangzhou 510520, Guangdong Province, China, He Xuan ,   Guangzhou Xinhua University, Guangzhou 510520, Guangdong Province, China, Luo Dan ,   Guangzhou Xinhua University, Guangzhou 510520, Guangdong Province, China, Su Jia-Yi ,   Guangzhou Xinhua University, Guangzhou 510520, Guangdong Province, China, Wang Wei ,   Guangzhou Xinhua University, Guangzhou 510520, Guangdong Province, China, Wang Rui-Xin ,   State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510623, Guangdong Province, China, Yu Xin-Ping ,   State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510623, Guangdong Province, China
Published: January 2025

AIM: To investigate the underlying factors by establishing a new paradigm for assessing control ability under stereopsis testing conditions.
METHODS: This was a prospective observational study. We evaluated the control ability of intermittent exotropia (IXT) patients in three conditions: natural 2D optotype viewing, 2D optotype viewing with polarized glasses, and 3D optotype viewing with polarized glasses. Recording with a smartphone, we captured videos to analyze the accurate time of spontaneous exodeviation and subsequent realignment before and after breaking fusion. Additionally, the correlation of stereopsis were also analyzed.
RESULTS: A total of 48 patients (age range: 4-33y; 54.17% male) participated in the study. When viewing 3D optotypes with polarized glasses, their median control scores were 1 (interquartile range, 0-4) at distance and 0 (0-1) at near. These scores were significantly better than those observed under natural viewing conditions, which were 2.5 (1-5) at a distance and 1 (0-3) at near (Friedman test, P=0.049). Furthermore, those subjects who exhibited exophoria (realignment within 2 seconds) while viewing 3D optotypes with polarized glasses were more likely to have measurable stereo vision (Kendall’s τb=-0.344, P=0.018).
CONCLUSION: IXT patients exhibit enhanced control ability when using polarized glasses to view 3D optotypes, notably improving realignment capabilities. This expands our understanding of current tests and offers a potentially sensitive method for assessing IXT severity.