An Automatic Strabismus Screening Method with Corneal Light Reflex based on Image Processing

Strabismus is one of the most common disease that might be associated with vision impairment. Especially in infants and children, it is critical to detect strabismus at an early age because uncorrected strabismus may go on to develop amblyopia. To this end, ophthalmologists usually perform the Hirschberg test, which observes corneal light reflex (CLR) to determine the presence and type of strabismus. However, this test is usually done manually in a hospital, which might be difficult for patients who live in a remote area with poor medical access. To address this issue, we propose an automatic strabismus screening method that calculates the CLR ratio to determine the presence of strabismus based on image processing. In particular, the method first employs a pre-trained face detection model and a 68 facial landmarks detector to extract the eye region image. The data points located in the limbus are then collected, and the least square method is applied to obtain the center coordinates of the iris. Finally, the coordinate of the reflective light point center within the iris is extracted and used to calculate the CLR ratio with the coordinate of iris edges. Experimental results with several images demonstrate that the proposed method can be a promising solution to provide strabismus screening for patients who cannot visit hospitals.