PURPOSE To evaluate the validity of the photographic assessment with a translucent cover that is clinically available for the evaluation of intermittent exotropia. METHODS Photographs of 270 patients who cooperated for the prism and alternate cover test (PACT) were reviewed. Full-face images were obtained with a digital camera while a translucent cover was placed in front of either eye. The change in distance from the medial canthus to the nasal limbus with occlusion was measured and the photographic angle was estimated by three independent ophthalmologists based on representative photographs. These two measurements were correlated with the angle measured using the PACT, and clinical features related to the discrepancy between the photographic angle and the angle measured with the PACT were determined. RESULTS Patients with intermittent exotropia of 27.0 ± 6.1 prism diopters (PD) showed a 4.5 ± 3.3 mm exodrift and an estimated angle of 29.0 ± 4.3 PD on the photographs with occlusion. The exodrift distance and photographic angle were positively correlated with the angle of PACT (r = 0.256, P < .001 and r = 0.546, P < .001, respectively). Of the 47 patients with a discrepancy of greater than 8 PD, 38 patients (80.9%) were regarded as having a photographic angle that was larger than the angle of PACT, which was more common in older patients, in those with a small distance angle, and when taking off the spectacles. CONCLUSIONS Photographs with a translucent cover can reveal the latent components of intermittent exotropia. However, the photographic angle might differ from the real angle, particularly in older patients with a small angle and with the spectacles off. [J Pediatr Ophthalmol Strabismus. 2021;58(5):331-338.].

中文翻译：

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使用半透明罩对间歇性外斜视进行摄影评估。

目的 评估临床上可用于评估间歇性外斜视的半透明罩的摄影评估的有效性。方法 回顾了 270 名合作进行棱镜和替代覆盖测试 (PACT) 的患者的照片。全脸图像是用数码相机获得的，而半透明的盖子放在两只眼睛的前面。测量了从内眦到鼻缘闭塞的距离变化，并由三位独立的眼科医生根据代表性照片估计了摄影角度。这两个测量值与使用 PACT 测量的角度相关，并确定了与摄影角度和使用 PACT 测量的角度之间差异相关的临床特征。结果 间歇性外斜为 27.0 ± 6.1 棱镜屈光度 (PD) 的患者在有遮挡的照片上表现出 4.5 ± 3.3 mm 的外偏移和 29.0 ± 4.3 PD 的估计角度。外漂移距离和摄影角度与 PACT 的角度呈正相关（分别为 r = 0.256，P < .001 和 r = 0.546，P < .001）。在47例PD差异大于8的患者中，38例（80.9%）被认为拍摄角度大于PACT的角度，这在老年患者中更常见，在距离角较小的患者中, 以及摘下眼镜时。结论 带有半透明封面的照片可以揭示间歇性外斜视的潜在成分。但是，拍摄角度可能与实际角度不同，尤其是小角度和摘下眼镜的老年患者。[J Pediatr Ophthalmol 斜视。2021;58(5):331-338.]。