Duction ranges in normal probands and patients with Graves' ophthalmopathy, determined using the Goldmann perimeter

We examined whether the Goldmann perimeter is suitable for measuring the range of monocular ductions, especially in the follow-up of patients with Graves' ophthalmopathy.

Using the Goldmann perimeter, the range of monocular ductions was determined in one eye of 100 normal probands (aged between 21 and 70 years) and of 36 patients (aged between 29 and 66 years) with a motility disturbance due to Graves' ophthalmopathy. Subjects were asked to follow target I/4e which was slowly moved by the examiner in the vertical and the horizontal meridian. The end-point of the pursuit movement observed by the examiner was taken as the duction limit. Subjects were measured twice, in half of the cases by the same, in the other half by two different examiners.

In the 100 normal probands, the mean ranges of ductions were: elevation 37.6 degrees, depression 58.0 degrees, adduction 51.6 degrees, abduction 48.7 degrees. There was a slight age-related decline. The intraobserver and interobserver mean coefficients of variation ranged between 1.5% and 3.8%. In the 36 patients with Graves' ophthalmopathy the coefficients were between 0.7% and 2.3%. In both the normal probands and the Graves' ophthalmopathy patients, the coefficients were smaller for the total vertical and horizontal duction ranges than for adduction, abduction, elevation and depression alone.

Measurements of the range of monocular ductions with the Goldmann perimeter are highly reproducible and appear to be suitable for follow-up studies in patients with Graves' ophthalmopathy.