Sensitivity and Specificity of Sheard and Percival’s Criteria for the Diagnosis of Young People with Near-heterophoria

Saif Hassan  Alrasheed; Amel Mohamed   Yousif; Majid A.  Moafa; Abd Elaziz Mohamed Elmadina; Mohammad  Alobaid

doi:10.3889/oamjms.2021.6399

Authors

Saif Hassan Alrasheed Department of Optometry, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
Amel Mohamed Yousif Department of Binocular Vision, Faculty of Optometry and Visual Sciences, Al-Neelain University, Khartoum, Sudan
Majid A. Moafa Department of Optometry, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia https://orcid.org/0000-0002-5075-018X
Abd Elaziz Mohamed Elmadina Department of Optometry, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
Mohammad Alobaid Department of Optometry, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia https://orcid.org/0000-0002-0676-9246

DOI:

https://doi.org/10.3889/oamjms.2021.6399

Keywords:

Fusional reserve, Esophoria, Exophoria, Sheard’s criteria, Percival’s criteria

Abstract

BACKGROUND: Sheard and Percival assumed that symptoms from latent strabismus can be avoided if the relevant fusional vergence is adequate to support the heterophoria.

AIM: The aim of the study was to determine the sensitivity and specificity of Sheard’s and Percival’s criterion for the diagnosis of heterophoria.

METHODS: A cross-sectional hospital-based study was performed at Al-Neelain Eye Hospital Khartoum, Sudan from February to October 2019. Heterophoria was measured using Maddox Wing and fusional vergence using a prism bar. Thereafter, Sheard’s and Percival’s criteria were used for the diagnosis of heterophoria.

RESULTS: A total of 230 participants (age = 15–30 years; mean age = 19.34 ± 3.325 years) were recruited for this study. The Sheard’s criteria showed a high sensitivity of 87.2% and a low specificity of 8.0% for the diagnosing of exophoria, with positive and negative predictive values of 65.5% and 26%, respectively. The criteria showed a relatively low sensitivity of 77.8% and a specificity of 9.0% in the diagnosis of esophoria, with a positive and negative predictive values of 56% and 20%, respectively. Percival criteria showed high sensitivity 84.2% and low specificity 9.1% in diagnosing esophoria, with a positive and negative predictive value of 61.5% and 25%, respectively. On the other hand, the criteria showed low sensitivity 67.4% and specificity 13.8% in diagnosing exophoria, with positive and negative predictive value 61.9% and 17%, respectively.

CONCLUSION: Sheard’s and Percival’s criteria are useful in diagnosing binocular vision problems. Sheard’s criteria are accurate in diagnosing near exophoria and Percival’s criteria are more accurate in diagnosing near esophoria. Therefore, these criteria provide good clues and predictions for the diagnosis of binocular vision problems.

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