Computer-assisted assessment of ocular synkinesis: a comparison of methods.

OBJECTIVES/HYPOTHESIS To define an objective, easy to perform, rapid method for the assessment of ocular synkinesis by employing both the Facial Assessment by Computer Evaluation software and a modification of the Glasgow Facial Palsy Scale. STUDY DESIGN Retrospective study. METHODS Fifty normal subjects and 50 patients with known ocular synkinesis were studied. Measurements of ocular synkinesis were made using the semiautomated Facial Assessment by Computer Evaluation software, and a modification of the automated Glasgow Facial Palsy program. RESULTS The mean resting vertical palpebral fissure width of a normal eye was 10.17 mm (standard deviation [SD], 1.63 mm), and the degree of eye closure during smile was on average 21.56% (SD, 13.38%). Synkinetic eyes had a statistically significantly smaller resting palpebral fissure width on average (8.99 mm; SD, 1.61 mm; P < .001, t test), and a statistically significantly greater degree of narrowing during smiling (32.65%; SD, 13.68%; P < .001, t test). Using a modified synkinesis-determining application of the Glasgow Facial Palsy Scale did not consistently correlate with the Facial Assessment by Computer Evaluation program or clinical observations of eye closure during smiling (R = 0.251, Pearson correlation) and puckering (R = 0.253, Pearson correlation). CONCLUSIONS The Facial Assessment by Computer Evaluation program yields rapid, consistent, palpebral fissure width measurements, and when combined with a subjective self-assessment questionnaire yields a comprehensive measure of ocular synkinesis. Our modified application of the Glasgow Facial Palsy Scale did not appear to be a reliable method for quantitative ocular synkinesis assessment.