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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
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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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