Determination of exophthalmometry values in the North Indian population

Purpose: To determine exophthalmometry values (EV) in the north Indian population and to find its correlation with the age, gender, height, weight, body mass index (BMI), locality, and base value of the population. Methods: A total of 1000 eligible participants with 504 females and 496 males with age >5 years were included in this observational cross-sectional study. Age, gender, and locality of the subjects were noted. Hertel’s exophthalmometry was performed on all subjects. The exophthalmometry values and base values were recorded. Height and weight were measured for all participants. BMI was calculated using the parameters. Results: The overall mean exophthalmometry value (mm) was 14.94 ± 2.43 mm with a range between 8 and 22 mm. There was no significant difference in EV between the two eyes. Males recorded a significantly higher mean EV of 15.4 ± 2.51 mm as compared to females with a value of 14.49 ± 2.27 mm. Base value of Hertel’s exophthalmometer had a mean value 100.78 ± 5.63 mm and a range of 84–120 mm. Age, height, weight, BMI, and locality of the subjects were found to have a significant effect on the exophthalmometry as well as the base value of the population. A significant correlation was also seen between exophthalmometry values and base values of the population. Conclusion: Our study provided the normal exophthalmometric range for the north Indian population and also demonstrated the relationship of age, gender, height, weight, BMI, locality, and base value with the exophthalmometric values

Comparison of Measurement Methods of Exophthalmos and Its Forensic Significance / 法医学杂志

Objective To compare the differences between Hertel exophthalmometry and CT on exophthalmos measurement,and explore its practical application value in forensic medicine.Methods Fifty-six normal individuals without eye injuries or diseases were selected as the control group.The absolute values of exophthalmos were measured in the standardized CT image workstation.The difference of binocular exophthalmos was compared in normal group.Forty-seven cases with unilateral orbital fracture were divided into injured eye group and normal eye group according to the presence of binocular orbital fractures.The differences of the absolute values of eophthalmos from the same eye and the relative values of eophthalmos between two eyes for same person measured by Hertel exophthalmometry and CT were analyzed.Results There was no statistical difference of exophthalmos between the normal eyes measured by CT method.In the normal eye group,the absolute value of exophthalmos measured by CT method was (16.66±5.41) rm,which was (16.16±4.45)mm when measured by the Hertel exophthalmometry method.There was no statistical difference between two groups (P＞0.05).In the injured eye group,there was statistical difference between the absolute values of exophthalmos measured by two measurement methods (P＜0.05).There was no statistical difference of the relative values of exophthalmos between the injured eyes and the normal eyes by two measurement methods (P＞0.05).Conclusion CT method has a good consistency with Hertel exophthalmometry,which can be applied into the practice of medicolegal expertise.

Usefulness of Exophthalmos Measurement on Upgaze

PURPOSE: To evaluate the usefulness of exophthalmos measurement on upgaze in patients who are not able to expose corneal vertex on primary gaze. METHODS: The present study included 39 patients with blow out fracture, pseudotumor, or thyroid associated ophthalmopathy and 21 people who don't have any ocular disease. In total, 60 people had exophthalmometry using Hertel exophthalmometer on the basis of corneal vertex, inferior limbus, and inferior sclera by three examiners. RESULTS: The relative exophthalmometry in normal group was 0.71 +/- 0.75 mm, 0.67 +/- 0.62 mm, and 0.69 +/- 0.60 mm on the basis of corneal vertex, inferior limbus, and inferior sclera, respectively. The relative exophthalmometry in exophthalmic group was 1.10 +/- 0.99 mm, 1.13 +/- 0.99 mm, 1.10 +/- 0.91 mm on the basis of corneal vertex, inferior limbus, and inferior sclera, respectively. The relative exophthalmometry in enophthalmic group was 0.79 +/- 0.90 mm, 0.74 +/- 0.92 mm, 0.74 +/- 0.87 mm on the basis of corneal vertex, inferior limbus, and inferior sclera, respectively. There was no statistically significant difference between different measuring points (p > 0.05). The inter-examiner reproducibility was shown to be highly reliable. CONCLUSIONS: The upgaze exophthalmometry on the basis of inferior limbus or inferior sclera would be useful in the patients who are not able to expose corneal vertex on primary gaze.

Exophthalmometric Values With Hertel Exophthalmometers in Children

PURPOSE: To investigate the normal exophthalmometric values in children and facilitate the exophthalmic evaluation in pediatric patients with orbital disease. METHODS: We measured 516 eyes in 258 children aged 3 to 9 years without any orbital disease such as thyroid ophthamopathy, orbital pseudotumor and orbital wall fracture. We considered the association of age, sex, binocular variance, inter rim distance and axial length with the exophthalmometric values. Axial length was measured in only 120 eyes of60 patients who underwent operation for strabismus. RESULTS: The mean exophthalmometric values in the patients was 12.43+/-1.55 mm. The exophthalmos had a significant positive correlation with the age, axial length and inter rim distance. There were significant differences in exophthalmometric values by sex in children aged from 8 to 9 years but no significant difference by binocular variance. There were significant differences in the inter-rim distance related to sex. CONCLUSIONS: The exophthalmometric values in children had significant correlation with age, sex, axial length, and inter-rim distance. There was a significant increase of inter-rim distance in males compared to females. Knowing the mean exophthalmometric values in children would be useful with the exophthalmometric reference in pediatric patients with orbital disease.

Exophthalmometric values of Korean using Hertel and Naugle exophthalmometers

PURPOSE: The purpose of this study was to propose the mean exophthalmometric values of Korean using both Hertel and Naugle exophthalmometers. METHODS: We measured 176 eyes in 88 (Male 45, Female 43) normal subjects without any orbital disease using both Hertel and Naugle exophthalmometers. RESULTS: The analysis of Hertel measurements showed a mean reading of 17.2+/-1.5 mm in the male group, and of 16.1+/-1.4 mm in the female group, respectively. And the analysis of Naugle measurements showed a mean reading of 19.5+/-1.1 mm in the male group, and of 18.3+/-1.3mm in the female group, respectively. There was no difference among different age groups in male and female groups, respectively. The exophthalmometric value of Naugle measurement was significantly higher than that of Hertel measurement in both male and female groups by 2.3 mm and 2.2 mm respectively (p<0.05). CONCLUSIONS: In Korean, the exophthalmometric value of Naugle instrument is larger than Hertel in both male and female. And there is significant difference between male and female, but no difference among different age groups. These data can be useful for mean exophthalmometric value of Korean.

Comparison of Reproducibility between Exophthalmometer Readings Measured with Hertel and Naugle Exophthalmometer

Hertel and Naugle exophthalmometers were used to compare the variability and reproducibility, produced by various observers. Five examiners measured fifty two eyes of twenty-six normal subjects each by using two different exophthalmometers, respectively. The average coefficient of variation among five measurements was 5.6% in the right eye, 5.2% in the left eye and 2.1% in base line by Hertel exophthalmometer. The average coefficient of variation measured by Naugle exophthalmometer was 1.9% in both eyes and 0.8% in pupillary distance. In conclusion, Naugle exophthalmometer showed less variability and better reproducibility; it is more appropriate for comparative exophthalmetry.

A Comparison of Hertel Exophthalmometer Measurements Between Various Manufacturer`s Models

To detect differences among the measurements of the Hertel exophthalmometers at different bar sizes and with different anufacturer`s models, exophthalmometries were performed for 27 normal subjects and 24 patients with thyroid ophthalmopathy at the three different bar sizes and with the models of three different manufacturers. The measurements decreased with the decrease of the bar size and increased with the increase of the bar size in all situations. The measurements of three different manufacturer`s models at the same bar size were different from each other. Therefore, Hertel exophthalmometries should be performed at the same bar size and with the same manufacturer`s model to find the exact changes of exophthalmos between repetitious examinations.