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Accurate assessment of extraocular muscle mechanics is crucial for diagnosing and treating ocular motility disorders, yet current methods, such as the forced duction test, rely on subjective tactile sensation and gross visual observation. To overcome the limitations of subjectivity and the impracticality of previous quantitative devices, we developed a novel biosensing system capable of simultaneously and objectively measuring passive ocular tension and rotation angle during forced duction. The system integrates custom-engineered surgical forceps equipped with dual strain gauges and an infrared video camera that precisely tracks pupil displacement to calculate real-time rotation angle. We clinically validated this system in a prospective study involving 10 patients (20 eyes) with intermittent exotropia, with measurements performed under general anesthesia. Reliable tension–angle curves were successfully obtained in all cases without complications. Passive tension increased progressively with ocular rotation, following a linear-parabolic trajectory up to 40°. The mean duction force of the medial and lateral rectus muscles showed comparable symmetry. This lightweight, practical, and objective biosensing system offers a reliable tool for quantifying ocular mechanics, with the potential to enhance diagnostic accuracy, enable individualized surgical planning, and support fundamental research in ocular motility disorders.
Doh et al. (Tue,) studied this question.