A new study has shown a smartphone could allow ophthalmologists to more easily measure abnormal eyeball protrusion due to Graves orbitopathy and other intraorbital conditions.

Of 39 patients, the smartphone showed relatively high accuracy and precision, interoperator reliability, and test-retest reliability for measuring exophthalmos compared with the historic standard and a high-resolution threedimensional scanner, the researchers reported.

There were no significant differences between the three techniques among 23 patients and 16 healthy volunteers, with a mean difference in eyeball protrusion of 3.3mm and 0.8mm, respectively.

The smartphone was convenient to use and didn’t require much skill, Dr Konrad Weber, of the University of Zurich, and his team noted in their article in JAMA Ophthalmology. 1

They said the traditionally used Hertel exophthalmometer was invented more than a century ago and “may be difficult to operate by an inexperienced examiner, prone to reading errors, and may have poor interoperator reliability and test-retest reliability in clinical practice”.

An app is not yet available, with the team now working on developing one.


  1. Popov, T., Fierz, F.C., Bockisch, C.J., et al., Using smartphone exophthalmometry to measure eyeball protrusion, JAMA Ophthalmol Published online September 21, 2023. doi:10.10