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§Model Card

Abnormal Lid Position Assessment AI (OpenFace)

Automated measurement of vertical palpebral aperture (VPA) from 2D facial photographs

Thomas P.B.M. · 2020 · UK · doi:10.1097/GOX.0000000000003089
Open DOI
Measurement/Regression Classical ML External photo Internally validated
More attributes
Anatomy · Periorbital soft tissueConditions · PtosisConditions · blepharoptosisSingle-centern = NR patients · 128 eyes images
§01Overview

Brief overview

OpenFace applies open-source facial landmark detection and constrained local neural field models to automated assessment of abnormal lid position from standard full-face photographs. In a feasibility study of 128 eyes from pre- and postoperative ptosis images, AI-derived vertical palpebral aperture measurements showed good agreement with clinician measurements (Pearson’s r = 0.87; 94.4% of observations within 2 SDs on Bland–Altman analysis). The system functioned across variable image quality without specialized imaging hardware and supports real-time webcam-based inference. Source code and downloadable pretrained models are publicly available through GitHub, although no dedicated clinical deployment or external multi-centre validation was reported. The platform represents one of the earliest openly accessible AI facial-analysis approaches applied to oculoplastic assessment.

§02Performance
Headline performance

Automated vs manual VPA/IPD: r = 0.87 (r² = 0.76); 94% of values within Bland–Altman limits of agreement. Robust to wide variation in image

Full metrics — as reported
Automated vs manual VPA/IPD: r = 0.87 (r² = 0.76); 94% of values within Bland–Altman limits of agreement. Robust to wide variation in image resolution.
Calibration · Uncertainty
Not reported.
Bias · Fairness
Not reported.
§03Data & Validation
Study designRetrospective cohort
Center typeSingle-center
PatientsNot reported
Images / eyes128 eyes
SplitNot reported
Reporting frameworks None stated
Age range>18
Sex (% female)Not reported
Race / ethnicity reportedN
Subgroup performanceN
§04Deployment
Deployment maturity
  1. Concept
  2. Prototype
  3. Internal val.
  4. External val.
  5. Regulator
  6. Clinical
Regulatory status
None No FDA / Health Canada / CE clearance.
Artifacts & license
Code repository Pretrained weights
Live demo none
License Custom (specify) — BSD-style open-source license
§05Quality Review · APPRAISE-AI
Total score
37 /100 Low
ClinicalDataMethodRobust.Report.Repro.
Sub-domain scores
Clinical relevance 4/4 100%
Data quality 8/24 33%
Methodological conduct 4/20 20%
Robustness of results 8/20 40%
Reporting quality 9/12 75%
Reproducibility 4/20 20%
Why this score?

The APPRAISE-AI tool grades AI/ML medical studies across 24 items in 6 subdomains, scored independently by two reviewers. The total reflects the methodological transparency of the publication — not the underlying clinical value of the model.

How to read this: high scores in clinical relevance and reporting with low scores in methodological conduct, robustness, or reproducibility is the dominant pattern in ophthalmic AI today.

Quality bands: Low <40 · Moderate 40–59 · High 60–79 · Very High 80+. Most published ophthalmic AI sits in the Low–Moderate band; studies that break into High typically combine multi-center datasets, prospective evaluation, and open-source release.

§06Full Metadata
Citation & identification
Bibliographic record
Model IDoculoplastics_thomas_2020
Full author listGunasekera, C. D., Kang, S., & Baltrusaitis, T.
JournalPlast Reconstr Surg Glob Open
DOI10.1097/GOX.0000000000003089
ConditionsPtosis, blepharoptosis
Architecture
Model internals
Architecture familyClassical ML
Architecture detailOpenFace landmark detection with custom post-processing, producing scale-normalized VPA/IPD ratios for ptosis assessment
Funding & conflicts
Disclosures
FundingNR
Conflicts of interestPeter B. M. Thomas is supported by the National Institute for Health Research (NIHR) Moorfields Biomedical Research Centre.
Card lifecycle
Status, version, reviewers
Card statusPublished
Card versionv1.0.0
First added2026-04-28
Last reviewed2026-04-28
Reviewersattribution opt-in pending
Update history
Card changelog
  • 2026-04-28 initial publication (v1.0.0)
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