Digital smartphone versus analogue methods of measuring orbital implant motility after enucleation

Abstract

Purpose: To compare standard rule measurement (gold standard, analogue) method of orbital implant motility against digital image analysis on smart phone measurement software, Medigrid and ImageJ. Design(s): Single centre observational, non-randomised, non-masked cohort study in enucleated patients. Method(s): A standard rule measurement (gold standard) was used to measure vertical and horizontal movements of the fellow eye, prosthesis, and orbital implant. At the same time, photographs taken in the same positions of gaze were analysed using ImageJ software (NIH, Bethesda, Maryland, USA) and the smartphone app mediGrid (IRISS Medical Technologies, UK). Bland-Altman plots were used to compare the digital modalities, with the current gold standard. Result(s): A total of 54 patients were tested for fellow eye motility, ocular prosthesis and orbital implant motility following primary enucleation. The median time since enucleation was 282 days (range: 45-11,278). Image-J had consistently lower limits of bias and agreement than mediGrid, suggesting that image-J is more equivalent to the standard rule measurement. The largest difference in the limit of agreement between mediGrid and ImageJ can be found most in upgaze and downgaze. Conclusion(s): In our analyses, Image-J was found to be a more accurate measure of orbital implant motility, than mediGrid. Copyright © The Author(s) 2025.