Nixon et al. [1]. reported on the feasibility study of a Strabismus screening Test using Augmented Reality and Eye-tracking (STARE). STARE uses augmented reality and eye-tracking. Fresnel prisms were used to provoke horizontal misalignments of a known magnitude in seven orthotropic controls. The authors previously reported results in their first (“development”) phase of this study. In the second (“validation”) phase, nineteen individuals with strabismus were recruited. The STARE measurements were then compared with the gold standard test, the alternate prism cover test (APCT). The authors found that STARE can rapidly screen for strabismus using a consumer augmented reality headset with integrated eye-tracking, with an area under the curve of 1.00 for detecting horizontal strabismus, mean difference {95% CI} of 2.1 {−1.8, 9.9} prism dioptres and Pearson correlation between STARE and the APCT of r24 = 0.62, P < 0.001 [1].

The diagnosis of strabismus and exact measurement of ocular deviation currently requires a highly skilled examiner adept at using prisms such as a paediatric ophthalmologist or an experienced orthoptist. In underserved countries lacking in ophthalmic resources, there is not sufficient experts available to perform these assessments. Our group is currently developing a NASA-funded, multimodal, visual assessment system to monitor astronaut visual function during long-duration spaceflight, which features the assessment of visual acuity, contrast sensitivity, Amsler grid metamorphopsia, dynamic visual acuity among other tests [2, 3]. A future goal of our work is for this augmented reality technology to be potentially used in underserved and remote regions to help detect visual impairments [4]. We applaud Nixon et al. [1]. for their development and for making the screening tool open-source.

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