Methods
[ edit]- Hertel exophthalmometers take a measurement from the lateral orbital rim to the corneal apex. If a patient presents with...
- Naugle exophthalmometers use fixation points slightly above and below the superior and inferior orbital rims (cheek...
- Luedde exophthalmometers fix on the lateral orbital wall and use a transparent ruler to measure the amount of...
How do you use a Hertel exophthalmometer?
The Hertel exophthalmometer is used to determine the axial position of the eyes. The instrument is placed on the lateral orbital rim of each side, using as small of a base as possible. Depending on the device, lines on the prism are placed into position by moving the examiners view point to determine the measurement.
What does an exophthalmometer measure?
Hertel Measurements An exophthalmometer is used to measure the prominence of the eye; most commonly, the Hertel exophthalmometer is used (Figure 14.1). It measures the anterior projection of the eye, from the lateral orbital rim to the cornea (Table 14.1).
What is a Hertel measurement used for?
Hertel measurement / Hertel exophthalmometer. The Hertel exophthalmometer is used to determine the axial position of the eyes. The instrument is placed on the lateral orbital rim of each side, using as small of a base as possible.
How should the reference cone of an exophthalmometer be aligned?
Keeler, the manufacturers of the exophthalmometer, recommend that the reference cone is aligned with the reference line on the millimetre scale and the position of the anterior surface of the cornea on the millimetre scale noted (method 2).
What is a normal Hertel measurement?
Caucasians tend to have Hertel exophthalmometry measurements of less than 18 to 20 mm, which is higher than that of Asians (16 to 18 mm) and lower than those seen in many blacks (20 to 22 mm).
How do you examine by an exophthalmometer?
General Eye Examination The examiner faces the patient, palpates the patient's lateral orbital rims, places the concave sites on the side of the Hertel instrument over each rim, and records the base (or distance between these two points) from the instrument.
How do you do a Hertel?
0:000:37Hertel measurement and Hertel exophthalmometer - YouTubeYouTubeStart of suggested clipEnd of suggested clipRight eye should be determined with the examiner's. Left eye and vice versa. The device measures theMoreRight eye should be determined with the examiner's. Left eye and vice versa. The device measures the distance between the lateral orbital rim and the most anterior portion of the cornea.
What kind of equipment is used for exophthalmos degree measuring?
There are various types of devices available for measuring the degree of proptosis. The Hertel exophthalmometer, invented by Hertel in 1905, is the most widely used device to date1,2.
Why would an Exophthalmometer be used?
An exophthalmometer is an instrument used for measuring the degree of forward displacement of the eye in exophthalmos. The device allows measurement of the forward distance of the lateral orbital rim to the front of the cornea.
How do you use a Naugle Exophthalmometer?
0:002:11Exophthalmometer (Your EYEBALLS) 👁️👁️ - YouTubeYouTubeStart of suggested clipEnd of suggested clipMeasurement is taken from the lateral orbital rim to the corneal apex if a patient presents with anMoreMeasurement is taken from the lateral orbital rim to the corneal apex if a patient presents with an orbital fracture or after lateral orbital imme.
What is normal Proptosis?
It is suggested that the following "upper limits of normal" be used when clinically estimating proptosis: 19 and 21 mm for white female and male patients, respectively; and 23 and 24 mm for black female and male patients, respectively.
How is Enophthalmos measured?
A horizontal line (baseline) is drawn to connect the outermost of the bilateral anterior tips of the lateral walls. A vertical line is then drawn from the most prominent corneal part to the baseline. The length of this line is measured.
What is the difference between exophthalmos and proptosis?
Proptosis can describe any organ that is displaced forward, while exophthalmos refers to only the eyes. Proptosis can include any directional forward displacement.
How is proptosis diagnosed?
An eye doctor can diagnosis proptosis by examining your eye. They can use a special tool called an exophthalmometer to measure your level of eyeball protrusion. Your doctor will also review your medical history and ask you questions about your symptoms.
How do you measure dystopia?
-Horizontal dystopia :is measured by the distance from the midline of bridge of nose to the nasal limbus, compared bilaterally. -Vertical dystopia :is measured by the superior or inferior deviation of the central corneal reflex of the proptotic eye from a horizontal line passing through the centre of normal eye.
How is Enophthalmos measured?
A horizontal line (baseline) is drawn to connect the outermost of the bilateral anterior tips of the lateral walls. A vertical line is then drawn from the most prominent corneal part to the baseline. The length of this line is measured.
How is proptosis diagnosed?
An eye doctor can diagnosis proptosis by examining your eye. They can use a special tool called an exophthalmometer to measure your level of eyeball protrusion. Your doctor will also review your medical history and ask you questions about your symptoms.
Which instrument is used to view the inside of the eye with a bright light?
An ophthalmoscope is an instrument used for examining the interior structures of the eye, especially the retina.
What is Hertel exophthalmometer?
Hertel Measurements. An exophthalmometer is used to measure the prominence of the eye; most commonly, the Hertel exophthalmometer is used (Figure 14.1 ). It measures the anterior projection of the eye, from the lateral orbital rim to the cornea ( Table 14.1 ). When you use the Hertel exophthalmometer, be sure to lightly push ...
What is an exophalmometer?
Exophalmometer readings are particularly useful to monitor changes from thyroid eye disease or orbital mass. Enophthalmos can be indicative of orbital floor fracture or a cicatrizing lesion such as metastatic breast cancer. The data are expressed as “x” millimeters right eye, “y” millimeters left eye, with a base of “z” millimeters.
How is proptosis measured?
Proptosis is measured using an exophthalmometer. This device takes a millimeter measurement of the distance between the anterior cornea and the temporal orbital rim for each eye. For an individual patient the measurement base is the distance between the two temporal orbital rim margins. Thus a consistent measurement of proptosis or enophthalmos ...
How to check for periorbital deformities?
The function of the infraorbital nerve should also be checked by gently stroking the upper cheek below the eye with a cotton swab or similar item. Infraorbital hypesthesia, crepitus, enophthalmos, and orbital deformity may indicate the presence of an orbital blow-out fracture.
Can an exophthalmometer measure enophthalmos?
Any enophthalmos, or inward displacement, can be measured relative to the fellow eye with an exophthalmometer. Any downward displacement of one globe, termed globe ptosis or dystopia, which occurs in an orbital floor fracture, for instance, can be measured relative to the normal higher eye. 72.
Which exophthalmometer is used to align the cornea?
E ditor ,—The common method used in Hertel exophthalmometry involves aligning the corneal apex with the reference cone on the exophthalmometer and noting the position of this alignment on the millimetre scale (method 1). Keeler, the manufacturers of the exophthalmometer, recommend that the reference cone is aligned with the reference line on the millimetre scale and the position of the anterior surface of the cornea on the millimetre scale noted (method 2).
Which scale is the reference cone on?
Keeler, the manufacturers of the exophthalmometer, recommend that the reference cone is aligned with the reference line on the millimetre scale and the position of the anterior surface of the cornea on the millimetre scale noted (method 2).
Which observer was more experienced?
A Wilcoxon statistical analysis was performed. Observer 2 was the more experienced.
Can exophthalmometry lead to false positives?
We believe this study shows that a failure to make clear the measurement method used in exophthalmometry can lead to clinically significant false positive results which could have serious implications in the management of these patients.
Where does the Hertel exophthalmometer take measurements?
Hertel exophthalmometers take a measurement from the lateral orbital rim to the corneal apex. If a patient presents with an orbital fracture or after lateral orbitotomy, the use of a Hertel exophthalmometer may be complicated because the lateral orbital rim serves as a reference point for this instrument. Consideration should be given to the use of the Naugle exophthalmometer in these cases.
What is the point of Naugle exophthalmometer?
Naugle exophthalmometers use fixation points slightly above and below the superior and inferior orbital rims (cheek bones and forehead). Naugle exophthalmometers measure the difference in proptosis between the two eyes, in contrast to the absolute measure obtained with the Hertel method.
What is the difference between an exophthalmometer and a Naugle?
There are several types of exophthalmometers: Hertel and Luedde exophthalmometers measure the distance of the corneal apex from the level of the lateral orbital rim, while Naugle exophthalmometers measure the relative difference between each eye.
What is the instrument used to measure the distance between the lateral orbital rim and the front of the cornea?
Exophthalmometer. An exophthalmometer is an instrument used for measuring the degree of forward displacement of the eye in exophthalmos. The device allows measurement of the forward distance of the lateral orbital rim to the front of the cornea.
