Conventional Versus Virtual Reality-Based Hess-Lancaster Assessment: Agreement and Repeatability in Ocular…

Cross-sectionalJournal of eye movement research· Jun 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

OphthalmologyCross-sectionalDiagnosisQ2IF 2.1

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 · Jun 2026 · Q2 in Ophthalmology

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

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Results

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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.

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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.

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

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

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