Exophthalmos measurement method and forensic clinical identification technical points
眼球突出度测量方法及法医临床鉴定技术要点

摘要

目的 剖析眼球突出度测量方法及法医临床鉴定技术要点。方法 选取我中心2023年1月至2025年12月受理的眼球突出法医临床鉴定案例20例，以CT/MRI检查结果作为判断眼球突出病理基础的客观金标准，采用Hertel眼球突出计法、Luedde眼球突出计法、超声测量法三种方法测量突出度，对比测量结果，梳理鉴定关键环节及技术要点。结果 20例案例中，单侧眼球突出14例（70.00%），双侧6例（30.00%）；损伤性16例（80.00%），病理性4例（20.00%）。Hertel法测量合格率最高（95.00%），误差最小（0.12±0.05mm），三者差异有统计学意义（P<0.05）。测量体位、配合度等是主要影响因素，18例（90.00%）鉴定结果与临床、案情一致。结论 CT/MRI是判定眼球突出病理基础的客观检查方法，为法医临床鉴定的核心依据；Hertel法可作为临床测量的优先选择，但需限定应用场景。

Abstract

Objective To analyze the methods for measuring exophthalmos and the key technical points in forensic clinical identification.
Methods 20 cases of forensic clinical identification of exophthalmos received by our center from January 2023 to December 2025 were selected. The CT/MRI examination results were used as the objective gold standard for judging the pathological basis of exophthalmos. Three methods, namely the Hertel exophthalmos meter method, the Luedde exophthalmos meter method, and the ultrasound measurement method, were used to measure the protrusion degree. The measurement results were compared, and the key steps and technical points of the identification were sorted out.
Results Among the 20 cases, 14 cases (70.00%) had unilateral exophthalmos, and 6 cases (30.00%) had bilateral exophthalmos; 16 cases (80.00%) were caused by injury, and 4 cases (20.00%) were pathological. The Hertel method had the highest measurement qualification rate (95.00%), the smallest error (0.12±0.05 mm), and the differences among the three methods were statistically significant (P<0.05). Measurement position, cooperation degree, etc. are the main influencing factors. The identification results of 18 cases (90.00%) were consistent with the clinical and case situations.
Conclusion   CT/MRI is an objective examination method for determining the pathological basis of exophthalmos and is the core basis for forensic clinical identification; the Hertel method can be used as the preferred choice for clinical measurement, but its application scenarios need to be limited.