Comparing Layperson Attention to Faces with Different Types of Facial Paralysis Using Eye-Tracking.

Area of Science:

• Ophthalmology
• Neurology
• Psychology

Background:

• Facial paralysis presents a spectrum from complete flaccid facial paralysis (CFFP) to facial aberrant reinnervation syndrome (FARS).
• Understanding how observers perceive these different facial paralysis subtypes is crucial for patient care and research.

Purpose of the Study:

• To objectively compare how laypersons direct attention to faces with CFFP and FARS using eye-tracking technology.
• To analyze gaze patterns during rest and dynamic facial expressions.

Main Methods:

• Eye-tracking was used to measure lay observers' gaze patterns on standardized videos of individuals with CFFP, FARS, and controls.
• Data on time spent looking at facial subsites were collected and analyzed using mixed-effects regression.

Main Results:

• At rest, CFFP faces drew more attention to the nonparalyzed side, unlike FARS and control faces which showed symmetric gaze.
• During dynamic movements (smiling, brow elevation), both CFFP and FARS faces exhibited altered and asymmetrical gaze patterns compared to controls.

Conclusions:

• Casual observers view faces with CFFP and FARS distinctively, with implications for clinical practice and future studies.
• CFFP alters gaze at rest and during movement, while FARS-related gaze alterations primarily occur during facial expressions.