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Subjective Refraction Test Using a Smartphone for Vision Screening
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Published on: October 18, 2024

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Using Smartphone Exophthalmometry to Measure Eyeball Protrusion.

Todor Popov1, Fabienne C Fierz2, Christopher J Bockisch1,2,3

  • 1Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

JAMA Ophthalmology
|September 21, 2023
PubMed
Summary

A new smartphone application for measuring eyeball protrusion shows high accuracy and reliability, offering a potential replacement for the traditional Hertel exophthalmometer. This innovation simplifies exophthalmos assessment in clinical settings.

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Area of Science:

  • Ophthalmology and Medical Technology
  • Biomedical Engineering and Imaging

Background:

  • The Hertel exophthalmometer, a historic tool for measuring eyeball protrusion, is prone to reading errors.
  • Accurate measurement of exophthalmos is crucial for diagnosing and managing conditions like Graves orbitopathy.
  • There is a need for a more reliable and accessible method for exophthalmos assessment.

Purpose of the Study:

  • To evaluate the accuracy, precision, and reliability of a novel smartphone application for measuring exophthalmos.
  • To compare smartphone exophthalmometry with established methods, including the Hertel exophthalmometer and a high-resolution 3D scanner.

Main Methods:

  • A cross-sectional study involving 39 participants (23 patients with exophthalmos, 16 healthy volunteers).
  • Measurements were taken twice by three operators using the smartphone app, Hertel exophthalmometer, and a 3D scanner.
  • Assessed accuracy, precision, test-retest reliability, and interoperator reliability.

Main Results:

  • Smartphone exophthalmometry demonstrated high accuracy and precision, comparable to the Hertel exophthalmometer and 3D scanner.
  • Intraclass correlation coefficients (ICCs) for agreement between smartphone and Hertel exophthalmometer were high (0.89).
  • High interoperator agreement (ICC, 0.95) and test-retest reliability (ICC, 0.93) were observed for the smartphone method.

Conclusions:

  • Smartphone exophthalmometry is a reliable and accurate method for measuring eyeball protrusion.
  • The findings support the potential of using smartphone applications as a viable alternative to the Hertel exophthalmometer.
  • This technology could enhance the accessibility and consistency of exophthalmos measurements in clinical practice.