The study by Vicinanzo et al1 has important implications for treatment of orbital fractures in particular, but it also uncovers larger issues that extend beyond treatment of this entity. In some respects, these larger problems carry much greater significance not just for ophthalmology but also for all of medicine.
In addition to intraobserver variability, interobserver variability has been well recognized as a potential problem in other areas of radiology.2,3 This problem is magnified as required measurements increase from 1 to 2 or 3 dimensions. The authors of these studies, much like Vicinanzo and colleagues, urge caution when placing an inordinate reliance on radiologic measurements when making clinical decisions.