Videographic evaluation of blinking patterns and their association with dry eye.

Authors

Roee Arnon, Joel Gutovitz, Orit Ezra-Nimni, Irit Barequet, Daphna Landau-Prat, Guy J Ben Simon

Published in

Orbit (Amsterdam, Netherlands). Pages 1-7. Nov 09, 2026. Epub Nov 09, 2026.

Abstract

To investigate the association between spontaneous blinking patterns and dry eye disease (DED) severity.
In this single-center, cross-sectional study, patients attending cataract, general ophthalmology, and DED clinics were categorized by Ocular Surface Disease Index (OSDI) score as having no, mild, moderate, or severe DED. Spontaneous blinking was recorded using a high-speed smartphone camera and blindly analyzed by a senior oculoplastic surgeon for brow lift, blepharospasm, imbrication, lagophthalmos, eyelid margin rotation, retraction, lid separation delay, lash ptosis, dermatochalasis, and increased tear lake. DED was assessed using OSDI, tear break-up time (TBUT), Schirmer's test, and fluorescein and lissamine-green staining. Only the right eye was included.
Fifty-four patients (mean age, 65.3 years; 31 women) were included. TBUT, Schirmer's test, fluorescein staining, and eyelid margin rotation differed significantly across OSDI severity groups (p = 0.030, p = 0.016, p = 0.001, and p = 0.011, respectively). Patients with moderate-to-severe DED (OSDI ≥ 23) had shorter TBUT, lower Schirmer's values, higher fluorescein staining scores, and a higher frequency of eyelid margin rotation during blinking than those with lower OSDI scores (p = 0.011, p < 0.008, p < 0.001, and p = 0.037, respectively). This association remained significant after adjustment for age, sex, blepharitis, and meibomian gland dysfunction (adjusted OR, 4.29; 95% CI, 1.12-16.40; p = 0.033).
Moderate-to-severe DED was associated with a higher frequency of eyelid margin rotation during blinking. Larger studies are warranted to confirm these findings and explore potential eyelid-targeted therapeutic approaches.

PMID:
43003769
Bibliographic data and abstract were imported from PubMed on 10 Nov 2026.

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