Abstract
Purpose: To compare horizontal white-to-white (WTW) corneal diameter measurements in children with the MultiMeasureTM iPhone application versus a caliper and evaluate the repeatability of MultiMeasureTM. Methods: This prospective, comparative pilot study enrolled 20 children. The horizontal WTW diameter was measured with calipers with the patient in primary gaze (caliper group). Subsequently, corneal photography was performed with the iPhone in primary gaze (primary group) and with a 20° head turn (HT group). MultiMeasureTM was used to measure WTW. To evaluate repeatability of MultiMeasureTM, WTW was measured in 15 children from a clinic while awake (repeatability group) in primary gaze and with a 20° head turn. Three measurements were performed for all patients. Statistical significance was indicated by p<0.05. Results: The mean age of the sedated patients was 8.3 years (range, 2 to 15 years). The mean WTW was 11.68 ± 0.41 mm, 11.85 ± 0.28 mm and 11.34 ± 0.47 mm in the caliper, primary and HT groups respectively. There was a statistically significant difference between measurements in the caliper and HT groups only (p=0.006). Inter-test variability was not statistically significant different (p=0.45 primary group, p=0.37 HT group, p=0.37 caliper group). The mean age of 15 patients in the repeatability group was 7.6 years (range, 3 to 15 years). In the repeatability group, there was a statistically significant mean difference of 0.36 mm between the repeatability group in primary gaze versus head turned (p=0.001). Conclusion: The smart phone application was a fast, convenient, non-contact, repeatable method for measuring the corneal diameter in children in primary gaze.
Highlights
Corneal diameter measurement is essential in children suspected with congenital glaucoma or in the presence of other congenital corneal anomalies [1,2]
The corneal diameter is typically measured with a contact caliper which requires topical anesthesia, sedation or general anesthesia
We evaluate the repeatability of measurements of the software application and the effect of corneal diameter measurement based on head position
Summary
Corneal diameter measurement is essential in children suspected with congenital glaucoma or in the presence of other congenital corneal anomalies [1,2]. The corneal diameter is typically measured with a contact caliper which requires topical anesthesia, sedation or general anesthesia. An easier, more efficient method would be a non-contact measurement of corneal diameter without requiring sedation, topical or general anesthesia. Corneal photography has been used to measure corneal diameter noninvasively [3,4,5]. Photography is a non-contact method, a number of steps are involved that preclude application in routine clinical practice. Smart phones have incorporated excellent photography and zoom functions that could have clinical applications. Smart phones are ubiquitous, relatively inexpensive and portable
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