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Use of Crossed Polarizers to Enhance Images of the Eyelids

O'Sullivan, Ryan BA; Tom, Lisa M. MD; Bunya, Vatinee Y. MD; Nyberg, William C. FBP, FOPS; Massaro-Giordano, Mina MD; Daniel, Ebenezer MBBS, MS, MPH, PhD; Smith, Eli BA; Brainard, David H. PhD; Gee, James PhD; Maguire, Maureen G. PhD; Stone, Richard A. MD

doi: 10.1097/ICO.0000000000001157

Purpose: To describe imaging of the external eye with Crossed Polarizers to enhance clinically important features in digital photographs of the eyelids.

Methods: External photographs with and without crossed polarizing filters were taken of patients with blepharitis and controls with no clinical eye pathology.

Results: Photographing eyelid skin through Crossed Polarizers decreased reflections on the skin surface and improved visualization of eyelid telangiectasias and blood vessels in patients with a broad range of skin pigmentation and ethnicities.

Conclusions: The use of Crossed Polarizers in imaging the external eye reduces reflections and glare from the eyelid skin and margins, thereby allowing for a more detailed evaluation of underlying structures and analysis of images. These findings suggest that including Crossed Polarizers in clinical photography has informative applications for assessing eyelid disease.

*Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA;

Center for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA;

Departments of §Psychology; and

Radiology, University of Pennsylvania, Philadelphia, PA.

Reprints: Vatinee Y. Bunya, MD, Scheie Eye Institute, University of Pennsylvania, 51 N. 39th St, Philadelphia, PA 19104 (e-mail:

Supported by National Eye Institute grants K12 EYE015398 (V.Y.B.), R01 EY026972 (V.Y.B.) and core grant P30 EY001583, the Paul and Evanina Bell Mackall Foundation Trust (R.A.S.), and an unrestricted grant from Research to Prevent Blindness (V.Y.B., M.M.G., M.G.M., and R.A.S.).

M. Massaro-Giordano owns stock in Physician Recommended Nutriceuticals. R. A. Stone received an honorarium from Santen, Inc., in 2016 for a seminar and travel expenses, and is coinventor on 3 patents licensed to EyeIC but does not receive any royalties. The remaining authors have no conflicts of interest to disclose.

R. O'Sullivan and L. M. Tom are co-first authors.

† Deceased.

The Eyelid Photography Protocol is copyright-protected by the University of Pennsylvania. Use of the protocol in investigational studies sponsored in whole or part by for-profit entities or for commercial purposes by any entities is prohibited without the express written consent of the University of Pennsylvania. The authors retain intellectual rights to the photography protocol for the possibility of future licensing (V.Y.B., D.H.B., M.M.G., W.C.N., M.G.M., and R.A.S.).

Received July 26, 2016

Received in revised form November 11, 2016

Accepted November 16, 2016

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.