Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May-Jun;85(3):263-268.
doi: 10.5935/0004-2749.20220041.

Smartphone as a tool for evaluating oblique muscle dysfunction

Yessa Vervloet Bertollo Lamego Rautha  1 , Luis Eduardo Morato Rebouças de Carvalho  2 , Marcelo Francisco Gaal Vadas  2 , Carlos Fumiaki Uesugui  2 , Laís Yumi Sakano  2 , Ronaldo Boaventura Barcellos  2
Affiliations

Smartphone as a tool for evaluating oblique muscle dysfunction

Yessa Vervloet Bertollo Lamego Rautha et al. Arq Bras Oftalmol. 2022 May-Jun.

Abstract
in English, Portuguese

Purpose: The aim of this study was to describe a simple, accessible, and reliable method using a smartphone for evaluating oblique muscle dysfunctions.

Methods: The photograph rotation tool in the iPhone PHOTO app was used by 75 examiners to evaluate 22 photographs from only 9 patients, captured in infra- and supra-dextroversion, and infra- and supra-levoversion, as not all the patients were photographed in the 4 positions mentioned. Each patient received a score for the superior and inferior oblique muscle functions, ranging from -4 (hypofunction) to 4 (hyperfunction) or 0 (normal function), using preediting and postediting photographs. These values were compared with the scores previously given by trained personnel in strabismus screening. The difference in score between the two groups was expressed in natural (whole and non-negative) numbers. The mean and pattern deviation were then calculated.

Results: The scores of most of the edited photos showed a lower mean than those of the unedited ones, except for a patient with left superior oblique hyperfunction. The patients with no oblique dysfunction and those with right superior oblique hyperfunction demonstrated (after editing the photograph) scores with greater similarity with their initial scores (p<0.05 and p<0.01, respectively). Similar results were found in the patients with oblique hypofunctions and right inferior oblique hyperfunction (p<0.01).

Conclusion: The proposed method for assessing muscular function in vertical strabismus is reproducible, accessible, simple, and reliable, and provides better consistency to the admeasurement.

Objetivo: Descrição de um método simples, acessível e confiável para a medida das disfunções dos músculos oblíquos, utilizando-se smartphone.

Métodos: Foi utilizado o recurso de rotação de fotografias do aplicativo FOTOS do iPhone®; 75 examinadores avaliaram 22 fotos de 9 pacientes, obtidas em infra e supra dextroversão, infra e supra levoversão (nem todos os pacientes foram fotografados nas 4 posições citadas). Conferiu-se aos pacientes uma pontuação para a função do músculo oblíquo superior e músculo oblíquo inferior, que variou de -4 (negativo para hipofunção) a +4 (positivo para hiperfunção), ou 0 (normofuncionantes), antes e depois da edição das fotografias. Esses valores foram comparados à avaliação prévia atribuída pelos assistentes do estrabismo. Computou-se a diferença da pontuação entre eles em números naturais (inteiros e não negativos); foram calculadas média e desvio padrão dessas medidas.

Resultado: A medida da maioria das fotos editadas apresentou média inferior as não editadas, à exceção de um paciente com hiperfunção de oblíquo superior esquerdo. Pacientes sem disfunção de oblíquos demonstraram, após edição das fotos, maior similaridade com o valor inicialmente determinado (p<0,05), assim como os pacientes com oblíquo superior direito hiperfuncionantes (p<0,01). Os mesmos resultados são encontrados nos pacientes com hipofunção dos oblíquos e hiperfunção de oblíquo inferior direito (p<0,01).

Conclusão: O método utilizado para medida das funções musculares nos estrabismos verticais é reprodutível, acessível, simples, confiável, e confere maior uniformidade à aferição.

PubMed Disclaimer

Conflict of interest statement

Disclosure of potential conflicts of interest: None of the authors have any potential conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Patients with hypofunction in the right inferior oblique muscle (A, before editing and B, after editing).
Figure 2
Figure 2
Screenshot showing how to edit the image with the iPhone Photos app. (A) The word “edit” was selected; (B) at the bottom left-hand corner, next to “cancel,” the edit icon was selected.
Figure 3
Figure 3
Screenshot showing how to edit the image on the iPhone Photos app. The photo shows formatting with a compass in the inferior margin. (A) As the compass is activated by pressing it, a grid image overlaps the photo. (B) The photo is rotated to align the horizontal lines with the limbus of the targeted eye.
See this image and copyright information in PMC

References

    1. Bicas HE. Oculomotricidade e seus fundamentos. Arq Bras Oftalmol. 2003;66(5):687–700.
    1. Souza-Dias C, Goldchmit M. Os Estrabismos: teoria e casos comentados. Rio de Janeiro: Cultura Médica, Guanabara Koogan; 2011. pp. 1–650.
    1. Corrêa AB, Mendonça TF. Recuo assimétrico dos músculos retos horizontais para correção de incomitância alfabética: relato de caso. Arq Bras Oftalmol. 2013;76(3):197–199. - PubMed
    1. Oliveira LO, Ginguerra MA, Polati MA. Disfunções dos músculos oblíquos nas variações alfabéticas. Arq Bras Oftalmol. 2001;64(6):535–539.
    1. Stager D Jr, Dao LM, Felius J. Uses of the inferior oblique muscle in strabismus surgery. Middle East Afr J Ophthalmol. 2015;22(3):292–297. - PMC - PubMed

LinkOut - more resources