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Exophthalmometry: a comparative study of the Naugle and Hertel instruments
H P Cole1, J T Couvillion, A J Fink
1Department of Ophthalmology, Tulane University School of Medicine, New Orleans, Louisiana, USA.
Ophthalmic Plastic and Reconstructive Surgery
|November 5, 1997
Summary
The Naugle exophthalmometer offers more repeatable measurements for proptosis evaluation than the Hertel device. Both instruments provide similar accuracy for globe position, but the Naugle is more comfortable and measures vertical differences.
Area of Science:
- Ophthalmology
- Medical Devices
- Clinical Measurement
Background:
- Exophthalmometry is crucial for evaluating proptosis (bulging eyes).
- Existing instruments like the Hertel exophthalmometer have limitations in repeatability and observer variability.
- A new superior and inferior orbital rim-based exophthalmometer (Naugle) has been developed.
Purpose of the Study:
- To compare the clinical usefulness of the Naugle exophthalmometer against the Hertel exophthalmometer.
- To assess the repeatability and observer variability of both instruments.
- To obtain normal values and analyze potential race and sex differences in exophthalmometry.
Main Methods:
- Part 1: Double-blind study measuring 135 patients to evaluate serial measurement repeatability and comfort of both instruments.
- Part 2: Single observer measured 205 patients for multifaceted analysis, including race and sex differences.
- Statistical analysis including coefficients of variation and t-tests were employed.
Main Results:
- The Naugle exophthalmometer demonstrated significantly better repeatability in serial measurements compared to the Hertel exophthalmometer.
- Observer variability was lower with the Naugle instrument.
- Mean globe position measurements were statistically similar between the two instruments, but significant race differences were noted with both.
Conclusions:
- The Naugle exophthalmometer is a reliable and repeatable tool for exophthalmometry, comparable in accuracy to the Hertel instrument.
- The Naugle device offers improved patient comfort and the unique advantage of measuring vertical ocular deviations (hyperophthalmos and hypoophthalmos).