Stuteville Jennifer L, King Jeremy D, West Roger W
Oklahoma College of Optometry, Northeastern State University, Tahlequah, Oklahoma 74464, USA.
Optom Vis Sci. 2007 Sep;84(9):865-71. doi: 10.1097/OPX.0b013e3181559d82.
We studied a behavioral technique in which strabismics can reduce the detectability of their eye turn by appropriately redirecting their gaze. We tested the efficacy of this technique for various amounts of strabismus and different positions of gaze.
We took digital images of a model gazing in different lateral directions and digitally edited them to simulate fixation with one eye on different lateral locations whereas the other eye was misaligned from the first by +/-0, 6, 12, 18, 24, and 30 Delta. Then we asked 22 lay observers to examine each of the images and to report whether or not they perceived eye contact and normal gaze.
The observers reported that our model appeared to look normal and gave them eye contact two-thirds of the time for up to 18 Delta of exotropia and 12 of esotropia when she looked half her prismatic deviation to the side opposite her eye turn.
By appropriately directing their gaze, both exotropes and esotropes can improve the cosmetic appearance of their strabismus and increase the perception that they are looking at the observer. This may be useful during job interviews and other social encounters where eye contact and a good impression are critical. A drawback is that large amounts of strabismus may require the gazer to look far to the side of the observer's head where it may be difficult to maintain gaze and the observer's facial expression may be hard to read. However, all patients may be counseled on which eye to look at when engaging in conversation, as looking at the appropriate rather than the inappropriate eye can reduce the perceived amount of their strabismus. Also, when their portrait is being taken, the full amount of eccentric gaze could easily be used.
我们研究了一种行为技巧，斜视患者可通过适当地重新引导注视方向来降低其眼位偏斜的可察觉性。我们测试了该技巧对于不同程度斜视和不同注视位置的效果。
我们拍摄了一个模型向不同外侧方向注视的数字图像，并对其进行数字编辑，以模拟一只眼睛注视不同外侧位置，而另一只眼睛相对于第一只眼睛有±0、6、12、18、24和30棱镜度的偏斜。然后我们让22名普通观察者检查每张图像，并报告他们是否察觉到目光接触和正常注视。
观察者报告称，当我们的模型将其棱镜度偏差的一半看向与眼位偏斜相反的一侧时，对于高达18棱镜度的外斜视和12棱镜度的内斜视，模型看起来正常并在三分之二的时间里与他们有目光接触。
通过适当地引导注视方向，外斜视和内斜视患者都可以改善其斜视的外观，并增加他们正在看向观察者的感觉。这在求职面试和其他目光接触及良好印象至关重要的社交场合中可能会有用。一个缺点是，大量斜视可能需要注视者看向观察者头部一侧很远的地方，在那里可能难以保持注视，并且观察者的面部表情可能难以看清。然而，所有患者在交谈时都可以得到关于看哪只眼睛的建议，因为看向合适而非不合适的眼睛可以减少斜视的可察觉程度。此外，在拍摄他们的肖像时，可以轻松地使用全部的偏心注视。
