Estimating eyeball protrusion from body height, interpupillary distance, and inter-orbital distance in adults

Eyeball protrusion is one characteristic that must be assessed/predicted in craniofacial identification methods of skull-face superimposition and facial approximation. Previously it has been suggested that average exophthalmometry values, as measured on living individuals, should be used. However, it is unknown if proptosis prediction can be improved beyond the accuracy obtained when using mean values. Some authors have suggested that relationships between exophthalmos, height, interpupillary distance, and interorbital distance exist and it has been reported that these latter variables can be used to estimate eyeball projection. However, crucial tests are yet to be conducted. This study measures these variables and tests the accuracy of exophthalmometry means, a previously proposed prediction equation, and newly derived regression equations to determine which methods provide the best results. Data indicate that variation in exophthalmos is fairly small and as such prediction from other variables, like body height, are weak; thus, exophthalmometry means currently offer the best practical method of prediction. It should be noted that up to 2 mm error from either side of the mean is expected for 68% of cases.