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. 2022 Apr;26(2):60.e1-60.e5.
doi: 10.1016/j.jaapos.2021.11.012. Epub 2022 Mar 18.

Parent-provided photographs as an outcome measure for childhood chalazia

S Ayse Erzurum  1 , Rui Wu  2 , B Michele Melia  2 , Zhuokai Li  2 , Robert W Arnold  3 , David I Silbert  4 , John W Erickson  5 , Nicholas A Sala  6 , Raymond T Kraker  2 , Jonathan M Holmes  7 , Susan A Cotter  8 ; Pediatric Eye Disease Investigator Group
Affiliations

Parent-provided photographs as an outcome measure for childhood chalazia

S Ayse Erzurum et al. J AAPOS. 2022 Apr.

Abstract

Purpose: To determine whether smartphone photographs of children's eyelids are reliable for diagnosing the presence of chalazia.

Methods: In this prospective cross-sectional study, 60 participants, 7 months to 16.5 years of age, at four sites were enrolled; all participants had a chalazion measuring at least 2 mm on at least one eyelid based on an in-person clinical examination by a pediatric eye care professional. Smartphone photographs taken by the parent during the office visit were uploaded to the study website. A masked reader assessed each photograph for the presence or absence of chalazia; results were compared with the gold standard clinical examination results. Sensitivity and specificity for the presence of chalazion by eyelid were calculated.

Results: Photographs were available for 240 eyelids; 85 had at least one chalazion and 155 were without a chalazion based on clinical examination. The masked reader correctly classified 68 of 85 eyelids with at least one chalazion and 151 of 155 eyelids without chalazia for a sensitivity of 80% (95% CI, 72%-86%) and a specificity of 97% (95% CI, 94%-99%). Sensitivity improved to 89% for chalazia 5 mm or larger and 94% when superficially located within the eyelid.

Conclusions: Parental smartphone photographs appear to be useful in assessing chalazia in children as an alternative to in-office follow-up examinations. These photographs may be a valuable outcome measure in future clinical trials of chalazia treatment, especially when assessing larger lesions.

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