SPIEGELEXOPHTHALMOMETER User Manual

Oculus Hertel mirror exophthalmometer User manual Hertel mirror exophthalmometers are used to measure the eye’s exact protrusion out of the orbit (degree of proptosis) to determine its position along the sagittal axis. This examination is of particular interest in retrobulbar, space-occupying conditions such as inflammation, haemorrhaging and tumours. The distance between the lateral orbital rim and the corneal apex serves as the dimension of measurement. Under normal conditions, the distance between the apex of the cornea and the orbital wall is

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approx. 18 mm. This normal value should only be regarded as a statistical average, from which there may well be upward or downward deviations. Depending on the configuration of the osseous orbit, a value of 15 mm might be pathological whereas 21 mm might be normal. Continuous checks are therefore more useful than individual measurements. Physiologically, there are also certain differences in the degree of proptosis in each eye.

Approach: The examiner sits opposite the patient at eye level. The exophthalmometer is then positioned with the blue arced supports  at the temporal lateral orbital walls. The instrument is manoeuvred using both hands and firmly propped first against the right-hand orbital wall on the temporal side (which should be felt against the lowest part of the support point). The movable part is then set in such a way that the left-hand orbital wall lies against the lowest part of the arced support.

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