{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:59:37Z","timestamp":1760057977397,"version":"build-2065373602"},"reference-count":44,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>This study evaluated binocular visual function using automatic dual rotational Risley prisms (ADRRPs) to measure phoria and vergence ranges. Thirty-nine (mean age: 21.82 \u00b1 1.10 years; age range: 20\u201324 years) healthy adults with normal binocular vision participated. Each underwent baseline refraction exams followed by phoria and vergence tests conducted using both a phoropter with Maddox rods and the ADRRPs. The results revealed a strong positive correlation between the two instruments for distance phoria (r = 0.959, p &lt; 0.001) and near-phoria measurements (r = 0.968, p &lt; 0.001). For vergence testing, positive fusional vergence (PFV) at distance showed a moderate-to-strong correlation for break points (r = 0.758, p &lt; 0.001) and a moderate correlation for recovery points (r = 0.452, p &lt; 0.001). Negative fusional vergence (NFV) at distance demonstrated a strong correlation for break points (r = 0.863, p &lt; 0.001) and a moderate correlation for recovery points (r = 0.458, p &lt; 0.01). Near-vergence testing showed moderate-to-strong correlations for break points (r = 0.777, p &lt; 0.001) and recovery points (r = 0.623, p &lt; 0.001). The inclusion of Bland\u2013Altman analysis provides a more comprehensive evaluation of agreement between ADRRPs and the phoropter. While strong correlations were observed, systematic bias and LoA indicate that these methods are not perfectly interchangeable. The ADRRPs demonstrated potential for binocular vision assessment but require further validation for clinical application.<\/jats:p>","DOI":"10.3390\/s25051604","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T11:20:57Z","timestamp":1741173657000},"page":"1604","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Innovative Binocular Vision Testing for Phoria and Vergence Ranges Using Automatic Dual Rotational Risley Prisms"],"prefix":"10.3390","volume":"25","author":[{"given":"Hui-Rong","family":"Su","sequence":"first","affiliation":[{"name":"Ph.D. Program of Electrical and Communications Engineering, Feng Chia University, Taichung 407, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Jung","family":"Chen","sequence":"additional","affiliation":[{"name":"Ph.D. Program of Electrical and Communications Engineering, Feng Chia University, Taichung 407, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1260-0923","authenticated-orcid":false,"given":"Yun-Shao","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Chung Shan Medical University, Taichung 402, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi-Hung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, Feng Chia University, Taichung 407, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shang-Min","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Optometry, Central Taiwan University of Science and Technology, Taichung 402, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuan-Yu","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Optometry, Central Taiwan University of Science and Technology, Taichung 402, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1001\/jamaophthalmol.2020.0539","article-title":"Association of Strabismus with Functional Vision and Eye-Related Quality of Life in Children","volume":"138","author":"Hatt","year":"2020","journal-title":"JAMA Ophthalmol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1080\/09273970500455436","article-title":"The relationship between convergence insufficiency and ADHD","volume":"13","author":"Granet","year":"2005","journal-title":"Strabismus"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"325","DOI":"10.4103\/0301-4738.97553","article-title":"The relationship between binocular vision symptoms and near point of convergence","volume":"61","author":"Hamed","year":"2013","journal-title":"Indian J. Ophthalmol."},{"key":"ref_4","first-page":"716","article-title":"Binocular vision measurements with a new online digital platform: Comparison with conventional clinical measures","volume":"107","year":"2023","journal-title":"Clin. Exp. Optom."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e66","DOI":"10.1097\/MAO.0000000000002874","article-title":"Validation of the Binocular Vision Dysfunction Questionnaire (BVDQ)","volume":"42","author":"Feinberg","year":"2021","journal-title":"Otol. Neurotol."},{"key":"ref_6","first-page":"451","article-title":"Comparison of a Novel Binocular Refraction System with Standard Digital Phoropter Refraction","volume":"100","author":"Bossie","year":"2023","journal-title":"Optom. Vis. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1080\/08164622.2023.2266498","article-title":"Accuracy of an objective binocular automated phoropter for providing spectacle prescriptions","volume":"107","author":"Ozgur","year":"2023","journal-title":"Clin. Exp. Optom."},{"key":"ref_8","unstructured":"Benjamin, W.J. (2006). Monocular and binocular subjective refraction. Borish\u2019s Clinical Refraction, Elsevier. [2nd ed.]."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1111\/j.1475-1313.2007.00504.x","article-title":"Subjective refraction: The mechanism underlying the routine","volume":"27","author":"Harris","year":"2007","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3089","DOI":"10.1016\/S0042-6989(00)00162-0","article-title":"The influence of repetitive eye movements on vergence performance","volume":"40","author":"Yuan","year":"2000","journal-title":"Vis. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1080\/09286586.2019.1679192","article-title":"The Convergence Insufficiency Neuro-mechanism in Adult Population Study (CINAPS) Randomized Clinical Trial: Design, Methods, and Clinical Data","volume":"27","author":"Alvarez","year":"2020","journal-title":"Ophthalmic Epidemiol."},{"key":"ref_12","unstructured":"Elliott, D.B. (2020). Refraction and prescribing. Clinical Procedures in Primary Eye Care, Elsevier. [5th ed.]."},{"key":"ref_13","unstructured":"Carlson, N.B., and Kurtz, D. (2016). Refraction. Clinical Procedures for Ocular Examination, McGraw Hill Education. [4th ed.]."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1136\/bjo.80.1.35","article-title":"Clinical Evaluation of the Allergan Humphrey 500 Autorefractor and the Nidek AR-1000 Autorefractor","volume":"80","author":"Kinge","year":"1996","journal-title":"Br. J. Ophthalmol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1097\/00006324-199808000-00028","article-title":"The Repeatability of Automated and Clinician Refraction","volume":"75","author":"Bullimore","year":"1998","journal-title":"Optom. Vis. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1097\/00006324-199508000-00007","article-title":"Repeatability of Subjective and Objective Refraction","volume":"72","author":"Rosenfield","year":"1995","journal-title":"Optom. Vis. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ohlendorf, A., Leube, A., and Wahl, S. (2016). Steps Towards Smarter Solutions in Optometry and Ophthalmology\u2014Inter-device Agreement of Subjective Methods to Assess the Refractive Errors of the Eye. Healthcare, 4.","DOI":"10.3390\/healthcare4030041"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1167\/tvst.7.4.11","article-title":"Comparison between Aberrometry-based Binocular Refraction and Subjective Refraction","volume":"7","author":"Carracedo","year":"2018","journal-title":"Transl. Vis. Sci. Technol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1097\/01.opx.0000134906.98403.c3","article-title":"Clinical Evaluation of the Topcon BV-1000 Automated Subjective Refraction System","volume":"81","author":"Dave","year":"2004","journal-title":"Optom. Vis. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/j.1475-1313.1993.tb00441.x","article-title":"Clinical Evaluation of a Range of Autorefractors","volume":"13","author":"McCaghrey","year":"1993","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1046\/j.1475-1313.2001.00585.x","article-title":"Clinical Evaluation of the Shin-Nippon SRW-5000 Autorefractor in Adults","volume":"21","author":"Mallen","year":"2001","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1097\/00006324-199706000-00028","article-title":"Repeatability and Accuracy of Automated Refraction: A Comparison of the Nikon NRK-8000, the Nidek AR-1000, and Subjective Refraction","volume":"74","author":"Elliott","year":"1997","journal-title":"Optom. Vis. Sci."},{"key":"ref_23","first-page":"2325","article-title":"The Repeatability of Measurement of the Ocular Components","volume":"33","author":"Zadnik","year":"1992","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1046\/j.1475-1313.2001.00584.x","article-title":"SRW-5000 Autorefractor in Children","volume":"21","author":"Chat","year":"2001","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1046\/j.1475-1313.2001.00596.x","article-title":"Repeatability of Subjective Refraction in Myopic and Keratoconic Subjects: Results of Vector Analysis","volume":"21","author":"Raasch","year":"2001","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.optom.2014.11.001","article-title":"Comparison of Refractive Assessment by Wavefront Aberrometry, Autorefraction, and Subjective Refraction","volume":"8","author":"Bennett","year":"2015","journal-title":"J. Optom."},{"key":"ref_27","first-page":"60","article-title":"Binocular Refraction: A Simplified Clinical Routine","volume":"16","author":"Cowen","year":"1959","journal-title":"Br. J. Physiol. Opt."},{"key":"ref_28","unstructured":"Eskridge, J.B., Amos, J.F., and Bartlett, J.D. (1991). Binocular Refraction. Clinical Procedures of Optometry, J.B. Lippincott."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Kobashi, H., Kamiya, K., Handa, T., Ando, W., Kawamorita, T., Igarashi, A., and Shimizu, K. (2015). Comparison of Subjective Refraction under Binocular and Monocular Conditions in Myopic Subjects. Sci. Rep., 5.","DOI":"10.1038\/srep12606"},{"key":"ref_30","first-page":"1031","article-title":"Evaluation of Patient Visual Comfort and Repeatability of Refractive Values in Non-presbyopic Healthy Eyes","volume":"8","author":"Segura","year":"2015","journal-title":"Int. J. Ophthalmol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3189","DOI":"10.1007\/s40123-024-01055-1","article-title":"A Novel Device for Vergence Exercises: Testing Automatic Dual Rotational Risley Prisms on Asymptomatic Adults and Patients with Convergence Insufficiency","volume":"13","author":"Chen","year":"2024","journal-title":"Ophthalmol. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3361","DOI":"10.1007\/s40123-023-00832-8","article-title":"Immediate Effects of Vergence Exercises Using Automatic Dual Rotational Risley Prisms on Accommodative Lag and Facility","volume":"12","author":"Huang","year":"2023","journal-title":"Ophthalmol. Ther."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1080\/10543400701329422","article-title":"Agreement between methods of measurement with multiple observations per individual","volume":"17","author":"Bland","year":"2007","journal-title":"J. Biopharm. Stat."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1111\/j.1475-1313.2005.00270.x","article-title":"Comparison of near heterophoria tests under varying conditions on an adult sample","volume":"25","author":"Lam","year":"2005","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"395","DOI":"10.14479\/jkoos.2020.25.4.395","article-title":"Change in lateral phoria under a phoropter and trial frame in phoria tests","volume":"25","author":"Oh","year":"2020","journal-title":"J. Korean Ophthalmic Optom. Soc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1097\/01.opx.0000214316.50270.24","article-title":"Comparison of subjective heterophoria testing with a phoropter and trial frame","volume":"83","author":"Casillas","year":"2006","journal-title":"Optom. Vis. Sci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1111\/j.1475-1313.2009.00681.x","article-title":"Quantification of heterophoria and phoria adaptation using an automated objective system compared to clinical methods","volume":"30","author":"Han","year":"2010","journal-title":"Ophthalmic Physiol. Opt."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Mestre, C., Otero, C., D\u00edaz-Dout\u00f3n, F., Gautier, J., and Pujol, J. (2018). An automated and objective cover test to measure heterophoria. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0206674"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1167\/tvst.9.7.40","article-title":"Synchronization of a removable optical element with an eye tracker: Test case for heterophoria measurement","volume":"9","author":"Gantz","year":"2020","journal-title":"Transl. Vis. Sci. Technol."},{"key":"ref_40","first-page":"342","article-title":"Reliability of and Comparisons Among Methods of Measuring Dissociated Phoria","volume":"75","author":"Rainey","year":"1998","journal-title":"Optom. Vis. Sci."},{"key":"ref_41","first-page":"123","article-title":"Repeatability of Phoria Measurements in Clinical Practice","volume":"14","author":"Anstice","year":"2021","journal-title":"J. Optom."},{"key":"ref_42","first-page":"223","article-title":"Inter-Instrument Agreement for Vergence Range Assessments","volume":"14","author":"Facchin","year":"2021","journal-title":"J. Optom."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.optm.2010.01.012","article-title":"Vergence adaptation in clinical vergence testing","volume":"81","author":"McDaniel","year":"2010","journal-title":"Optometry"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1111\/j.1475-1313.2008.00583.x","article-title":"Repeatability and Agreement in Fusional Vergence Measurements","volume":"28","author":"Antona","year":"2008","journal-title":"Ophthalmic Physiol. Opt."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/25\/5\/1604\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:47:48Z","timestamp":1760028468000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/25\/5\/1604"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,5]]},"references-count":44,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["s25051604"],"URL":"https:\/\/doi.org\/10.3390\/s25051604","relation":{},"ISSN":["1424-8220"],"issn-type":[{"type":"electronic","value":"1424-8220"}],"subject":[],"published":{"date-parts":[[2025,3,5]]}}}