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| ORIGINAL ARTICLE |
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| Year : 2017 | Volume
: 4
| Issue : 2 | Page : 43-48 |
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Normal ranges of interorbital anthropometric values in healthy sudanese children
Mai Osman Babiker1, Mahgoub Saleem2
1 Outpatient Department, Khartoum Eye Teaching Hospital, Khartoum, Sudan
2 Department of Ophthalmology, Faculty of Medicine, Al-Neelain University, Khartoum, Sudan
| Date of Web Publication | 21-Sep-2017 |
Correspondence Address:
Mahgoub Saleem
Department of Ophthalmology, Faculty of Medicine, Al-Neelain University, Khartoum 11111, P.O. Box 10139
Sudan
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/bijo.bijo_1_17
Background: The knowledge of the normal ranges of interorbital anthropometric values among schoolchildren aged 6–15 years is very important because normal values of facial measurements, inner canthal distance (ICD), outer canthal distance (OCD), canthal index, and circumferential interorbital index are useful parameters in the evaluation and treatment of congenital or posttraumatic deformities of the cephalic and facial regions such as telecanthus, ocular hypotelorism, and craniosynostosis.
Objective: To assess the normal ranges of interorbital anthropometric values in schoolchildren and to measure the interorbital distances and to define the effects of age and gender in Al-Shifa area, Khartoum State.
Materials and Methods: Systematic interorbital anthropometric measurements were done in 980 schoolchildren aged 5–16 years. Measurements of far Interpupillary Distance (FIPD), Near Interpupillary Distance (NIPD), Outer Canthal Distance (OCD) and Inner Canthal Distance (ICD) were taken in all study population. Comparisons were made between their gender and age using the Chi-square test.
Results: In total, 980 individuals were studied. Out of these, 675 (68.9%) individuals were boys and 305 (31.1%) were girls. The mean age of the study group was 9.47 ± 2.71 years; there was a statistically significant difference in all measurements (P < 0.05) according to the age of the children. There was a statistically significant difference in FIPD and NIPD measurements (P < 0.05) between the males and the females.
Conclusion: Significant interorbital measurement differences were found between Sudanese children according to gender and age. The present study suggests that age and gender should be considered in Sudanese children in any orbital surgery. To individualize the treatment planning and diagnosis, it is important for the surgeons to have a knowledge of these local Sudanese interorbital norms.
Keywords: Anthropometric values, canthal index, craniosynostosis, far interpupillary distance, interorbital distances, interorbital index, near interpupillary distance, ocular hypotailorism, outer canthal distance and inner canthal distance, telecanthus
How to cite this article:
Babiker MO, Saleem M. Normal ranges of interorbital anthropometric values in healthy sudanese children. Albasar Int J Ophthalmol 2017;4:43-8 |
| Introduction | |  |
Quantitative and qualitative biometric measurements of the human body, especially facial measurements,[1] were used during the ancient protohistoric era, mostly practiced for the figurative arts. Eventually, the practice was adopted recently in medicine to facilitate scientific advances in medicine, imaging, and reconstructive technology.[2] Recently, the most fascinating use of human biometry is in forensic applications,[3] and security matters [4] as Legal Biometric Authentication [5] and biometric values in criminal investigation techniques in crime detection and prosecution processes are widely used in many Investigational Security Bureaus.[6]
Sudan is known for its different ethnic groups that comprise different racial origins. This diversion makes our knowledge about the Sudanese Norms is an urgent issue, the answer of which highlights our needs of hospital- and community-based ophthalmic Norm's studies.[7] As there are no data available in the literature, for Sudanese children's interorbital biometry, the present study was carried out to determine the normal average values for Sudanese schoolchildren related to age and gender to fill the gap of the missing data.
Therefore, there is a need of scientific knowledge for interorbital biometric anthropometry such as the measurements of the human far interpupillary distance (FIPD) and near interpupillary distance (NIPD), which are defined as the distance between the centers of the two pupils with the individual looking straight ahead (FIPD) or looking at a reading distance (NIPD).
Outer canthal distance (OCD) is the distance between the two lateral canthi with the individual looking straight ahead and inner canthal distance (ICD) is the distance between the two medial canthi with the individual looking straight ahead.[8],[9]
Among all Interorbital measurements; IPD is the best indicator of the distance between the centers of the globes.[8] There are significant differences in ocular and orbital morphometry among individuals of different age, sex, and ethnicity.[9]
| Materials and Methods | | |
This cross-sectional descriptive community-based study was conducted on schoolchildren aged 5–16 years in the month of September 2015. Ethical consideration was obtained prior to the conduction of the study from the Ministry of Health, Khartoum State. Children were selected in a structured random sampling rhythm: from ten (five boys and five girls) primary schools from a total of 23 (11 boys and 12 girls) primary schools at Al-Shifa area of Khartoum State, Sudan. The samples were collected from the first, fourth, and seventh grades – three classes in every school according to the school health program sampling in Khartoum State. The total participants were 980 Sudanese children: 675 (68.9%) boys and 305 (31.1%) girls. Cases with craniofacial or orbital deformities, eye deviation, media opacity, history of trauma and facial or orbital fractures, history of ocular surgery, thyroid eye disease, or any ophthalmic disease that interfered with the measurement of OCD, IPD, and ICD were excluded from the study.
Detailed standardized ophthalmic medical history and demographic data of all the participants were considered and reported in the predesigned “data collection forms” at the time of examination. Then, systematic interorbital anthropometric measurements were taken by a digital positive displacement (PD) meter (Shin Nippon PD Meter [Product Code: IDIPD82]) for IPDs (FIPDs and DIPDs) [Figure 1]. OCD and ICD were measured directly by a sliding caliper (vernier caliper) (from Neiko® 01407A electronic digital caliper with extra-large LCD screen, 0–6 inches) [Figure 2]. Sometimes, the IPD metery can be confirmed by a manual ruler IPD meter in uncooperative children. | Figure 2: Sex distribution of the average interorbital distance measurements and their standard deviations in Sudanese children of different age groups. IOD - Interorbital distance; SD - Standard deviation; FIPD - Far canthal distance; NIPD - Inner canthal distance; OCD - Outer canthal distance; ICD - Inner canthal distance
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The entire data were coded and entered in a Microsoft Excel spreadsheet in a personal computer and subjected to a statistical analysis by Statistical Package for the Social Sciences (SPSS) version 20 (manufactured by IBM SPSS Inc., PASW Statistics for Windows, Version 20.0; 2009. SPSS Inc., Chicago, IL, USA). Categorical variables were analyzed using frequencies and percentage. Continuous variables were summarized using mean, percentile, range, and standard deviation. Significant differences and associations were determined by P < 0.05.
| Results | | |
In total, 980 Sudanese children were studied. Out of these, 675 (68.9%) children were boys and 305 (31.1%) were girls [Figure 1]. The mean age of the participants was 9.47 ± 2.71 years (range: 6–16 years).
The average anthropometrical values of the two aspects of the IPD, FIPD, and NIPD were compared between the two genders using the Chi-square test (P = 0.022 and 0.033, respectively). The average FIPDs for boys and girls were 56.4207 ± 3.39215 mm and 55.7754 ± 3.71469 mm, respectively, and the NIPDs for both sexes were 53.2570 ± 3.19534 mm and 52.8000 ± 3.51187 mm, respectively.
[Table 1] demonstrates the distribution of the FIPDs in Sudanese children of different age groups, where those with 40–50 mm FIPD were only 35 (3.6%) children, those with 51–60 mm FIPD were the majority, i.e., 854 (87.1%), while those with ≥61 mm FIPD were 91 (9.3%) children [Table 1], [Table 2] and [Figure 2]. | Table 1: Sex distribution of the average interorbital distance measurements and their standard deviations in Sudanese children
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 | Table 2: Distribution of far interpupillary distances in Sudanese children of different age groups
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[Table 3] demonstrates the distribution of the NIPDs in Sudanese children of different age groups, where those with 40–50 mm NIPD were 230 (23.5%), those with 51–60 mm NIPD were the majority, i.e., 737 (75.2%), and those with ≥61 mm NIPD were few, i.e., only 13 (1.3%) children [Table 3], [Table 4] and [Figure 3]. | Figure 3: Distribution of far interpupillary distance in both sexes. FIPD - Far interpupillary distance (P = 0.022)
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 | Table 4: Distribution of near interpupillary distances in Sudanese Children of different age groups
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Therefore, there was a statistically significant difference in FIPD and NIPD measurements (P < 0.05) between the boys and the girls (P = 0.022 and 0.033, respectively).
The mean anthropometrical values of the interorbital distance (IOD) measurements were compared between the two genders using the Chi-square test, with P = 0.056, which is close to being statistically significant. The average OCDs for boys and girls were 90.0437 ± 4.9920 mm (9.0437 ± 0.49920 cm; P = 0.056).
[Table 5] and [Table 6] demonstrate the distribution of the OCD in Sudanese children of different age groups where those with <90 mm OCD (<9 cm OCD) were 248 (25.3%) children, while those with OCD ≥90 mm (≥9 cm OCD) were the majority, i.e., n = 732 (74.7%) [Table 5], [Table 6] and [Figure 4]. | Figure 4: Distribution of near interpupillary distance in both sexes. NIPD - Near interpupillary distance (P = 0.033)
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 | Table 6: Distribution of outer canthal distances in Sudanese children of different age groups
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[Table 7] and [Table 8] demonstrate the distribution of the ICD in Sudanese children of different age groups, where those with <30 mm ICD (<3 cm ICD) were 637 (65.0%), constituting the majority of studied children, while those with ICD ≥30 mm (≥3 cm ICD) were less, i.e., 343 (35%). The above OCD and ICD results [Table 5], [Table 6], [Table 7], [Table 8] and [Figure 5] reported a value of P = 0.056, which was “close to being statistically significant” in all measurements according to the age of children. | Figure 5: Distribution of the outer canthal distance in both sexes. OCD - Outer canthal distance (P = 0.056)
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 | Table 8: Distribution of inner canthal distances in Sudanese children of different age groups
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Consequently, the bulk of the studied children scored higher anthropometrical values: 51–60 mm FIPD in 854 (87.1%) and 51–60 mm NIPD in 737 (75.2%) children, OCD ≥90 mm and ICD ≥30 mm in 732 (74.7%) children each.
Generally, the percentage of boys who scored higher anthropometrical values within their sex (FIPD, NIPD, OCD, and ICD) was more than the percentage of girls who scored higher values within their sex: (1) 88.6% of the boys and 84.8% of the girls had 51–60 mm FIPD, (2) 77.6% of the boys and 69.8% of the girls had 51–60 mm NIPD, and (3) 75.3% of the boys and 73.4% of the girls had ≥ 90 mm OCD and ≥ 30 mm ICD, respectively [Table 5], [Table 6], [Table 7], [Table 8], [Table 9] and [Figure 4], [Figure 5], [Figure 6]. | Figure 6: Distribution of the inner canthal distance in both sexes. ICD - Inner canthal distance (P = 0.056)
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| Discussion | | |
Anthropometry is the measurement of human size: weight, shape, dimensions, and physical capabilities.[10]
Sudan is known for its different ethnic groups that comprise different racial origins. This diversity in ethnicities makes our knowledge about the Sudanese Norm's is urgently needed, by doing more Interorbital Anthropometric studies.[7] Therefore, there is a need of proper measurements of the interorbital values; such as the measurements of the human FIPD and NIPD, which are defined as the distance between the centers of the two pupils with the individual looking straight ahead (FIPD) or looking at a reading distance (NIPD), OCD is the distance between the two lateral canthi with the individual looking straight ahead and ICD is the distance between the two medial canthi with the individual looking straight ahead.[8],[9]. Among these parameters, IPD is the best indicator of the distance between the centers of the globes.[8] There are significant differences in ocular and orbital morphometry among individuals of different age, sex, and ethnicity.[9]
The dimensions of the human body are known to be affected by geographical, racial, ethnic, gender,[11] and age factors. Therefore, a normative data of periocular measurements based on the above factors could be indispensable in identifying ocular pathologies as well as in precisely determining the degree of deviation from the normal.[12]
As far as we know, very few studies have been done to establish interorbital anthropometric values in healthy Sudanese children. Therefore, this study was conducted to fill this gap of knowledge in these normative studies.
Bazmi and Zahir (Bangladesh) reported that in Bengali children the anthropometrical values (IOD) were significantly higher in boys than that of girls (P < 0.05),[13] at younger ages, i.e., 6–8 years, whereas they tend to be reversed at 12–14 years of age where the girls developed higher values than the boys. This is in contrary to the current study where the mean measurements of IOD remain higher in boys all through the childhood span.
The OCD of the current study (90.0276 ± 5.090 mm) was almost conforming with the scores of Gabriel et al., who reported 90.118 ± 0.65 mm OCD (Ikwerre schoolchildren in Nigeria, 2013),[14] while the current ICD score (30.150 ± 3.109 mm) was not in accordance with the scores of Gabriel et al. who recorded far bigger ICD in Nigerian's children, even up to 7 mm (27.3%) (37.00 ± 2.48 mm).[14]
Usman and Shugaba (2016)[15] in their study of the Bura ethnic group of North-Eastern Nigerian children within the age range 7–15 years obtained an FIPD of 60.1 ± 2.9 mm, which was >4 mm (>7%) higher than the current study of the Sudanese children, and an NIPD of 55.1 ± 2.7 mm, which was >2 mm (>4%) higher than the current study of the Sudanese children.
| Conclusion | | |
The results from the current study construe that there is a statistically significant (FIPD, NIPD; (P = 0.022 and 0.33) and “close to being statistically significant” (OCD, ICD; P = 0.056) interorbital measurement differences between Sudanese children according to gender and age. Generalization of “interorbital anthropometric values” for different sets of people from different ethnic groups impedes the right orbital or constructive treatment and surgery planning. It is important for the oculoplastic and maxillofacial surgeons and ocularists to have a knowledge of these local Sudanese interorbital measurement norms, which have been established in this study.
Recommendation
More studies are needed on other ocular anthropometric measurements to set a normative database of Sudanese population. Indirect anthropometry using standardized photography combined with computer analysis is recommended to perform a full anthropometric analysis of the eye.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9]
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