J Korean Ophthalmol Soc.  2021 Jul;62(7):873-880. 10.3341/jkos.2021.62.7.873.

Analysis of Eyelid Blink Characteristics in Patients with Ptosis Using a Smartphone Camera

• Joo T
• Joo JH
• Park IK
• Shin JH

• KMID: 2518488
• DOI: http://doi.org/10.3341/jkos.2021.62.7.873

Abstract

Purpose
To compare eyelid blink characteristics between patients with ptosis and healthy controls using a smartphone camera.
Methods
The ptosis group consisted of 20 senile aponeurotic ptosis patients with margin reflex distance1 ≤2.5 mm and the control group consisted of 10 healthy subjects without ptosis. The ptosis group was further divided into two groups based on an age cutoff of 70 years. Palpebral fissure height, levator function, margin reflex distance1, inter-blink interval, blink duration, blink rate, and blink velocity were measured and compared between the three groups based on photographs of the eyelids and videos of blinking taken with a smartphone camera.
Results
The palpebral fissure height, levator function, margin reflex distance1, and blink velocity were lower in the ptosis groups than in the control group but these values did not differ between the two ptosis groups. The palpebral fissure height, levator function, and margin reflex distance1 were correlated with blink velocity. In the receiver operating characteristic (ROC) curve of blink velocity, the area under the receiver operating characteristic (AUROC) curve value was as high as 0.969 and the cut-off value was 32.36 mm/s.
Conclusions
It is possible to analyze eyelid blink characteristics using a smartphone camera and the results confirmed that palpebral fissure height, levator function, margin reflex distance1, and blink velocity were lower in the senile aponeurotic ptosis group than in the healthy control group and were unaffected by age. Additionally, blink velocity is valuable for diagnosis of ptosis due to the correlation between the degree of ptosis, blink velocity, and the ROC curve of blink velocity.

Keyword

Blink velocity, Eyelid blink, Ptosis, Smartphone