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Ophthalmic Injuries
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
In the early stages following blunt orbital trauma, oedema and haemorrhage can increase the orbital volume, causing a transient proptosis (protruding eye) or masking the potential for enophthalmos. The degree of proptosis or enophthalmos should initially be assessed by careful observation, observing the patient whilst standing above and from the sides, although subsequent formal assessment with an exophthalmometer will be required following specialist referral.
The Endocrine System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
The basic screening tests used in initial evaluation of thyroid function include TT4 by radioimmunoassay (RIA), resin T3 uptake (RT3U or RT4U), free thyroxine index (FT.,1), thyroid-stimulating hormone (TSH) measurement, and free serum thyroxine (FT4). The term thyroid scan is often encountered, referring to administration of a radioactive compound and visualized by a scanner device. These procedures are often supplemented by a number of additional tests available for assessment of thyroid functions. For example, an exophthalmometer is used to measure the extent of protrusion of the eyeball. Thy roglobulin, the colloid protein secreted by the thyroid gland, is elevated when the thyroid is inflamed or enlarged; this can be measured in the serum by radioimmunoassay. Cholesterol levels can also be measured to determine a possible association with thyroid disorder.
One or More Bulging Eyes
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
Exophthalmometry: The exophthalmometer is used to measure axial proptosis. The make of the instrument should be documented (e.g. Keeler, Oculus) as they may give different horizontal width values even on the same patient. The difference between two eyes in a normal subject should be ≤2 mm. Upper limits are around 22 mm for Caucasians and 24 mm for Afro-Caribbeans. Beware that the accuracy of this test depends on symmetry of patient's lateral orbital rims which can be damaged by previous trauma, though the examiner's technique is by far the biggest variable!
Progressive proptosis secondary to pneumosinus dilatans of the ethmoidal sinus in a pediatric patient
Published in Orbit, 2021
Rebeca Rosés Sáiz, Elsa Font Julià, Félix García Ortega, Cristina Piñero Cutillas
Clinical examination revealed a proptosis of his left eye, with no masses or prominences evidenced. The overlying skin was normal. The rest of the left side of the face was also normal. Nevertheless, a mild hyper function of the inferior oblique muscles associated with V syndrome was evidenced (Figure 1a-b). Measures of the degree of exophthalmos were made with a Hertel exophthalmometer, resulting in 15 mm for the right eye, and 18 mm for the left eye (Figure 1c-d). Visual acuity and the rest of the clinical examination were unremarkable. Imaging tests such as computed tomography (CT) and magnetic resonance image (MRI) (Figure 2a-c) were indicated, which revealed an abnormal hyperaeration of the left anterior ethmoidal sinus, without any presence of mass or collection. A slight volume of mucus was found (see details in image 2a), with no pathological impact associated.
Influence of surgical approach for decompression on lower eyelid position in thyroid eye disease
Published in Orbit, 2020
Andrew W. Thorne, Daniel Benson Rootman
Data concerning demographics including age and sex, as well as medical and surgical history were obtained from patient records. Exophthalmometry measurements were performed by trained oculoplastic physicians or oculoplastics fellows utilizing a Hertel exophthalmometer. Digital photographs taken in primary position, with the patient looking directly into the camera, were obtained from a prospectively maintained imaging database. Preoperative and three-month postoperative photographs were assessed for each patient. Photographs were measured by a single researcher utilizing NIH ImageJ software (National Institutes of Health, Bethesda, Maryland). Individual images were standardized to a corneal diameter of 11.77 for males and 11.64 for females.9 MRD2 was measured as the vertical height from the center of the pupil to the lower eyelid margin.
Computed Tomography Measurements as a Standard of Exophthalmos? Two-Dimensional Versus Three-Dimensional Techniques
Published in Current Eye Research, 2018
Jie Guo, Jiang Qian, Yifei Yuan
The degree of exophthalmos and its change is an important parameter in the management of TED. The exophthalmometer is most frequently used measurement device in clinical evaluations of exophthalmos. However, the accuracy and reliability of measurements conducted with an exophthalmometer is influenced by clinician experience, the exophthalmometry procedure, soft tissue swelling and the different instrument types.9,10 The interobserver agreements of exophthalmometry varied from 30% to 82% when a ± 1 mm limit was used and could be weaker for less-experienced doctors or for proptosis patients.3,10–13 CT imaging helps to achieve more accurate values in exophthalmometry.11,14,15 In previous studies, the CT exophthalmos measurement was considered the standard for devices comparisons. Therefore, the accuracy and reliability of CT measurements is crucial.