Purpose
To measure the maximum angle of ocular versions using photographs of the 9 cardinal
positions and a modified limbus test.
Design
An evaluation of diagnostic technology; a prospective observational study.
Participants
We enrolled 104 healthy subjects, 20 to 40 years of age.
Methods
Photographs were obtained in the 9 cardinal positions of gaze and the images were
processed using Photoshop. The images were analyzed using the Image J program to measure
the angle of version. The maximum angle of the 9 cardinal positions was quantified
using a modified limbus test.
Main Outcome Measures
We measured the maximum angle of ocular versions in the 9 cardinal positions of gaze.
We also compared the results for males and females.
Results
The mean angles of maximum version were adduction 47.4°, abduction 46.4°, elevation
31.8°, depression 47.8°, elevation in adduction 39.7°, elevation in abduction 40.7°,
depression in adduction 52.7°, and depression in abduction 49.2°. The mean angle of
maximum elevation was significantly smaller than that of depression (
P <
0.001). There were no correlations between the angle of maximum version and age, spherical
equivalents, or axial length. The angle of maximum version for males was significantly
greater than that for females, except for inferior gaze.
Conclusions
A modified limbus test using photographs of the 9 cardinal positions is an objective
and reproducible tool for quantifying ocular movement. Considering its simplicity,
ease of use, and low cost, it has clear applications in clinical practice.
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Article Info
Publication History
Published online: January 10, 2014
Accepted:
November 4,
2013
Received in revised form:
October 30,
2013
Received:
August 2,
2013
Footnotes
Financial Disclosures: The authors have no proprietary or commercial interest in any of the materials discussed in this article.
Identification
Copyright
© 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
