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New research · Ophthalmology
Journal of eye movement research · 2d
Cross-sectionalJournal of eye movement research · 2026

Conventional Versus Virtual Reality-Based Hess-Lancaster Assessment: Agreement and Repeatability in Ocular Motility Evaluation.

Francisco Javier Povedano-Montero, Álvaro Perales-Serrano, Daniela León Lobo … Juan E Cedrún-Sánchez
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OphthalmologyCross-sectional

VR-based eye misalignment test shows moderate agreement with conventional test.

Conventional Versus Virtual Reality-Based Hess-Lancaster Assessment: Agreement and Repeatability in Ocular Motility Evaluation.

Francisco Javier Povedano-Montero … Juan E Cedrún-Sánchez
Journal of eye movement research · 2026
Background

The conventional Hess-Lancaster test is widely used to assess ocular misalignment across diagnostic gaze positions, but it relies on subjective responses and manual recording.

Purpose

To evaluate the agreement and within-method repeatability of point-by-point deviation measurements obtained with the conventional Hess-Lancaster test and a VR-based Hess-Lancaster assessment implemented in Dicopt Pro.

Methods

This cross-sectional observational study included 52 adults with suspected or diagnosed ocular motility disorders.

n = 52 adults
0.57
Results
0.57
vr and standard tests agreed moderately in pinpointing eye misalignment
n = 52 adults
More results

Mean bias was 1.22 prism diopters for the right eye and 0.10 prism diopters for the left eye.

Repeatability estimates were moderate-to-good, with ICC values ranging from 0.62 to 0.83, although repeated measurements were available only in a subset of participants.

“
Conclusion

The VR-based Hess-Lancaster assessment showed small mean differences and moderate agreement with the conventional test, although both methods should be interpreted within the context of the complete clinical examination.

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