{"id":"https://openalex.org/W7225629482","doi":"https://doi.org/10.21203/rs.3.rs-11437464/v1","title":"Automated Detection and Classification of Strabismus in Smartphone Images","display_name":"Automated Detection and Classification of Strabismus in Smartphone Images","publication_year":2026,"publication_date":"2026-11-09","ids":{"openalex":"https://openalex.org/W7225629482","doi":"https://doi.org/10.21203/rs.3.rs-11437464/v1"},"language":"en","primary_location":{"id":"doi:10.21203/rs.3.rs-11437464/v1","doi":"https://doi.org/10.21203/rs.3.rs-11437464/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11437464/v1","pdf_url":"https://www.researchsquare.com/article/rs-11437464/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.researchsquare.com/article/rs-11437464/latest.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5161351686","display_name":"Anoop Thazhathumanackal Radhakrishnan","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I151746483","display_name":"University of Waterloo","ror":"https://ror.org/01aff2v68","country_code":"CA","type":"education","lineage":["https://openalex.org/I151746483"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Anoop Thazhathumanackal Radhakrishnan","raw_affiliation_strings":["University of Waterloo"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Waterloo","institution_ids":["https://openalex.org/I151746483"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5053482510","display_name":"Brooke Koritala","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210127017","display_name":"Retina Foundation of the Southwest","ror":"https://ror.org/03sqq2g46","country_code":"US","type":"nonprofit","lineage":["https://openalex.org/I4210127017"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Brooke Koritala\u00b2","raw_affiliation_strings":["Retina Foundation of the Southwest"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Retina Foundation of the Southwest","institution_ids":["https://openalex.org/I4210127017"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161328993","display_name":"Robert F. Hess\u00b3","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I5023651","display_name":"McGill University","ror":"https://ror.org/01pxwe438","country_code":"CA","type":"education","lineage":["https://openalex.org/I5023651"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Robert F. Hess\u00b3","raw_affiliation_strings":["McGill University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"McGill University","institution_ids":["https://openalex.org/I5023651"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5031048152","display_name":"Otman Basir","orcid":"https://orcid.org/0000-0002-6454-0538","observed_orcids":["https://orcid.org/0000-0002-6454-0538"]},"institutions":[{"id":"https://openalex.org/I151746483","display_name":"University of Waterloo","ror":"https://ror.org/01aff2v68","country_code":"CA","type":"education","lineage":["https://openalex.org/I151746483"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Otman Basir\u2074","raw_affiliation_strings":["University of Waterloo"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Waterloo","institution_ids":["https://openalex.org/I151746483"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5065125938","display_name":"Eileen E. Birch","orcid":"https://orcid.org/0000-0001-8279-3291","observed_orcids":["https://orcid.org/0000-0001-8279-3291"]},"institutions":[{"id":"https://openalex.org/I4210127017","display_name":"Retina Foundation of the Southwest","ror":"https://ror.org/03sqq2g46","country_code":"US","type":"nonprofit","lineage":["https://openalex.org/I4210127017"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Eileen E. Birch\u00b2","raw_affiliation_strings":["Retina Foundation of the Southwest"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Retina Foundation of the Southwest","institution_ids":["https://openalex.org/I4210127017"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5161334705","display_name":"Benjamin Thompson\u00b9","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I151746483","display_name":"University of Waterloo","ror":"https://ror.org/01aff2v68","country_code":"CA","type":"education","lineage":["https://openalex.org/I151746483"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Benjamin Thompson\u00b9","raw_affiliation_strings":["University of Waterloo"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Waterloo","institution_ids":["https://openalex.org/I151746483"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11538","display_name":"Ophthalmology and Eye Disorders","score":0.5741999745368958,"subfield":{"id":"https://openalex.org/subfields/2731","display_name":"Ophthalmology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11538","display_name":"Ophthalmology and Eye Disorders","score":0.5741999745368958,"subfield":{"id":"https://openalex.org/subfields/2731","display_name":"Ophthalmology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11448","display_name":"Face recognition and analysis","score":0.19509999454021454,"subfield":{"id":"https://openalex.org/subfields/1707","display_name":"Computer Vision and Pattern Recognition"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T11438","display_name":"Retinal Imaging and Analysis","score":0.04149999842047691,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/strabismus-detection","display_name":"strabismus detection","score":0.9309999942779541},{"id":"https://openalex.org/keywords/strabismus-classification","display_name":"strabismus classification","score":0.8840000033378601},{"id":"https://openalex.org/keywords/corneal-light-reflex","display_name":"corneal light reflex","score":0.9049999713897705},{"id":"https://openalex.org/keywords/pupil-center-localization","display_name":"pupil center localization","score":0.9200000166893005},{"id":"https://openalex.org/keywords/interocular-asymmetry","display_name":"interocular asymmetry","score":0.9580000042915344},{"id":"https://openalex.org/keywords/esotropia","display_name":"esotropia","score":0.8309999704360962},{"id":"https://openalex.org/keywords/exotropia","display_name":"exotropia","score":1.0},{"id":"https://openalex.org/keywords/mask-r-cnn","display_name":"Mask R-CNN","score":0.8410000205039978},{"id":"https://openalex.org/keywords/smartphone-based-screening","display_name":"smartphone-based screening","score":0.7549999952316284},{"id":"https://openalex.org/keywords/children","display_name":"children","score":0.3619999885559082}],"concepts":[{"id":"https://openalex.org/C2776864138","wikidata":"https://www.wikidata.org/wiki/Q7620839","display_name":"Strabismus","level":2,"score":0.8827000260353088},{"id":"https://openalex.org/C2779532201","wikidata":"https://www.wikidata.org/wiki/Q2720759","display_name":"Esotropia","level":3,"score":0.6445000171661377},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.6389999985694885},{"id":"https://openalex.org/C31972630","wikidata":"https://www.wikidata.org/wiki/Q844240","display_name":"Computer vision","level":1,"score":0.5770999789237976},{"id":"https://openalex.org/C119767625","wikidata":"https://www.wikidata.org/wiki/Q618211","display_name":"Optometry","level":1,"score":0.5679000020027161},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.4860000014305115},{"id":"https://openalex.org/C2778207058","wikidata":"https://www.wikidata.org/wiki/Q2556242","display_name":"Exotropia","level":3,"score":0.4767000079154968},{"id":"https://openalex.org/C2777394604","wikidata":"https://www.wikidata.org/wiki/Q173318","display_name":"Pupil","level":2,"score":0.46619999408721924},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.41029998660087585},{"id":"https://openalex.org/C121958486","wikidata":"https://www.wikidata.org/wiki/Q609543","display_name":"Binocular vision","level":2,"score":0.38260000944137573},{"id":"https://openalex.org/C2776502983","wikidata":"https://www.wikidata.org/wiki/Q690182","display_name":"Contrast (vision)","level":2,"score":0.33719998598098755},{"id":"https://openalex.org/C118487528","wikidata":"https://www.wikidata.org/wiki/Q161437","display_name":"Ophthalmology","level":1,"score":0.3206000030040741},{"id":"https://openalex.org/C177264268","wikidata":"https://www.wikidata.org/wiki/Q1514741","display_name":"Set (abstract data type)","level":2,"score":0.2851000130176544},{"id":"https://openalex.org/C153180895","wikidata":"https://www.wikidata.org/wiki/Q7148389","display_name":"Pattern recognition (psychology)","level":2,"score":0.2809000015258789},{"id":"https://openalex.org/C2910741058","wikidata":"https://www.wikidata.org/wiki/Q796207","display_name":"Vision test","level":3,"score":0.26460000872612},{"id":"https://openalex.org/C3019060180","wikidata":"https://www.wikidata.org/wiki/Q184199","display_name":"Automated method","level":2,"score":0.25780001282691956},{"id":"https://openalex.org/C178195510","wikidata":"https://www.wikidata.org/wiki/Q17013040","display_name":"Facial symmetry","level":2,"score":0.25450000166893005}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.21203/rs.3.rs-11437464/v1","doi":"https://doi.org/10.21203/rs.3.rs-11437464/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11437464/v1","pdf_url":"https://www.researchsquare.com/article/rs-11437464/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.21203/rs.3.rs-11437464/v1","doi":"https://doi.org/10.21203/rs.3.rs-11437464/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-11437464/v1","pdf_url":"https://www.researchsquare.com/article/rs-11437464/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":0.9391000270843506}],"study_designs":[],"awards":[],"funders":[{"id":"https://openalex.org/F4320334506","display_name":"Canadian Institutes of Health Research","ror":"https://ror.org/01gavpb45"},{"id":"https://openalex.org/F4320334593","display_name":"Natural Sciences and Engineering Research Council of Canada","ror":"https://ror.org/01h531d29"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225629482.pdf","grobid_xml":"https://content.openalex.org/works/W7225629482.grobid-xml"},"referenced_works_count":14,"referenced_works":["https://openalex.org/W1989369677","https://openalex.org/W2011815372","https://openalex.org/W2065472685","https://openalex.org/W2164598857","https://openalex.org/W2801138896","https://openalex.org/W2801353795","https://openalex.org/W2806070179","https://openalex.org/W3119249131","https://openalex.org/W3134855576","https://openalex.org/W3172469186","https://openalex.org/W3188403016","https://openalex.org/W4317876190","https://openalex.org/W4386965026","https://openalex.org/W4407031880"],"related_works":["https://openalex.org/W4399812305","https://openalex.org/W3188403016","https://openalex.org/W7154378180","https://openalex.org/W4407031880","https://openalex.org/W2974281233","https://openalex.org/W4415468243","https://openalex.org/W7001195325","https://openalex.org/W2993614521","https://openalex.org/W7128472850","https://openalex.org/W4404135751"],"abstract_inverted_index":{"Abstract":[0],"Purpose":[1],"Accurate":[2],"detection":[3,59,158,215],"of":[4,121,149,172,181,192,208,218],"strabismus":[5,15,58,95,157,183,219,228,243],"from":[6,16,76,83,220,229],"smartphone":[7,125,221],"images":[8,126,152,222],"remains":[9],"challenging,":[10],"particularly":[11],"in":[12,18,87,197],"distinguishing":[13],"true":[14,227],"pseudo-strabismus,":[17],"which":[19],"apparent":[20],"ocular":[21],"misalignment":[22],"is":[23],"caused":[24],"by":[25],"facial":[26,77],"anatomy":[27],"rather":[28],"than":[29],"abnormal":[30],"eye":[31],"position.":[32],"This":[33],"study":[34],"developed":[35],"and":[36,54,60,73,96,132,169,179,216,223],"evaluated":[37],"a":[38,118],"fully":[39],"automated":[40,214],"smartphone-based":[41,242],"approach":[42,236],"that":[43],"explicitly":[44],"models":[45],"interocular":[46,209],"asymmetry":[47,80,211],"between":[48],"the":[49,84,88,193,198],"corneal":[50],"light":[51],"reflex":[52],"(CLR)":[53],"pupil":[55,71],"center":[56],"for":[57],"classification.":[61],"Methods":[62],"A":[63],"Mask":[64],"R-CNN":[65],"framework":[66],"was":[67,160,201],"trained":[68],"to":[69,93,239],"localize":[70],"centers":[72],"CLR":[74],"positions":[75],"images.":[78],"Geometric":[79],"parameters":[81],"derived":[82],"CLR-pupil":[85,210],"relationship":[86],"two":[89],"eyes":[90],"were":[91,142,153],"used":[92,117],"detect":[94],"classify":[97],"detected":[98],"cases":[99,107,196],"as":[100,110,145,184,203],"horizontal":[101,106,182],"or":[102,112,186],"vertical":[103],"deviations,":[104],"with":[105,134,162],"further":[108],"classified":[109,144],"esotropia":[111,185],"exotropia.":[113],"The":[114],"final":[115],"evaluation":[116],"separate":[119],"set":[120,200],"205":[122],"clinically":[123],"labeled":[124],"comprising":[127],"orthotropic":[128,139],"children,":[129],"pseudo-strabismus":[130,195],"cases,":[131],"children":[133],"strabismus.":[135,204],"Results":[136],"Of":[137],"110":[138],"images,":[140],"107":[141],"correctly":[143,154],"orthotropic,":[146],"while":[147],"87":[148],"95":[150],"strabismic":[151],"identified.":[155],"Overall":[156],"accuracy":[159],"94.63%,":[161],"96.67%":[163],"precision,":[164],"91.58%":[165],"sensitivity,":[166],"97.27%":[167],"specificity,":[168],"an":[170],"F1-score":[171],"94.06%.":[173],"Horizontal-versus-vertical":[174],"classification":[175,180,217],"achieved":[176,188],"95.40%":[177],"accuracy,":[178],"exotropia":[187],"96.15%":[189],"accuracy.":[190],"None":[191],"12":[194],"test":[199],"misclassified":[202],"Conclusion":[205],"Explicit":[206],"modeling":[207],"enables":[212],"accurate":[213],"may":[224],"help":[225],"distinguish":[226],"pseudo-strabismus.":[230],"Following":[231],"prospective":[232],"clinical":[233],"validation,":[234],"this":[235],"has":[237],"potential":[238],"support":[240],"accessible":[241],"screening.":[244]},"counts_by_year":[],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2026-11-10T00:00:00"}