Purpose: To compare a custom Photogrammetry for Anatomical CarE (PHACE) system with other cost-effective 3-dimensional (3D) facial scanning systems to objectively characterize morphology and volume of periorbital and adnexal anatomy. Methods: The imaging systems evaluated include the low-cost custom PHACE system and commercial software product for the iPhone called Scandy Pro (iScandy) application (Scandy, USA), and the mid-priced Einscan Pro 2X (Shining3D Technologies, China) device and Array of Reconstructed Cameras 7 (ARC7) facial scanner (Bellus3D, USA). Imaging was performed on a manikin facemask and humans with various Fitzpatrick scores. Scanner attributes were assessed using mesh density, reproducibility, surface deviation, and emulation of 3D printed phantom lesions affixed above the superciliary arch (brow line). Results: The Einscan served as a reference for lower cost imaging systems because it qualitatively and quantitatively renders facial morphology with the highest mesh density, reproducibility (0.13 ± 0.10 mm), and volume recapitulation (approximately 2% of 33.5 μL). Compared to the Einscan, the PHACE system (0.35 ± 0.03 mm, 0.33 ± 0.16 mm) demonstrated non-inferior mean accuracy and reproducibility root mean square (RMS) compared to the iScandy (0.42 ± 0.13 mm, 0.58 ± 0.09 mm), and significantly more expensive ARC7 (0.42 ± 0.03 mm, 0.26 ± 0.09 mm). Similarly, the PHACE system showed non-inferior volumetric modeling when rendering a 124 μL phantom lesion compared to the iScandy and more costly ARC7 (mean percent difference from the Einscan: 4.68 ± 3.73%, 9.09 ± 0.94%, and 21.99 ± 17.91% respectively). Conclusions: The affordable PHACE system accurately measures periorbital soft tissue as well as other established mid-cost facial scanning systems. Additionally, the portability, affordability, and adaptability of PHACE can facilitate widespread adoption of 3D facial anthropometric technology as an objective measurement tool in ophthalmology. Precis: We demonstrate a custom system for facial photogrammetry (Photogrammetry for Anatomical CarE -PHACE) to produce 3D renderings of facial volume and morphology which compares with more expensive alternative 3D scanning technologies.

Introduction: Clinical tools are neither standardized nor ubiquitous to monitor volumetric or morphological changes in the periorbital region and ocular adnexa due to pathology such as oculofacial trauma, thyroid eye disease, and the natural aging process. We have developed a low-cost, three dimensionally printed PH otogrammetry for A utomated C ar E (PHACE) system to evaluate three-dimensional (3D) measurements of periocular and adnexal tissue. Methods: The PHACE system uses two Google Pixel 3 smartphones attached to automatic rotating platforms to image a subject’s face through a cutout board patterned with registration marks. Photographs of faces were taken from many perspectives by the cameras placed on the rotating platform. Faces were imaged with and without 3D printed hemispheric phantom lesions (black domes) affixed on the forehead above the brow. Images were rendered into 3D models in Metashape (Agisoft, St. Petersburg, Russia) and then processed and analyzed in CloudCompare (CC) and Autodesk’s Meshmixer. The 3D printed hemispheres affixed to the face were then quantified within Meshmixer and compared to their known volumes. Finally, we compared digital exophthalmometry measurements with results from a standard Hertel exophthalmometer in a subject with and without an orbital prosthesis. Results: Quantification of 3D printed phantom volumes using optimized stereophotogrammetry demonstrated a 2.5% error for a 244μL phantom, and 7.6% error for a 27.5μL phantom. Digital exophthalmometry measurements differed by 0.72mm from a standard exophthalmometer. Conclusion: We demonstrated an optimized workflow using our custom apparatus to analyze and quantify oculofacial volumetric and dimensions changes with a resolution of 244μL. This apparatus is a low-cost tool that can be used in clinical settings to objectively monitor volumetric and morphological changes in periorbital anatomy.

Objectives: This study aims to develop and evaluate a novel slit‐lamp‐based system to acquire 3‐dimensional (3D) ultrasound volumes using conventional ultrasound probes. Methods: A slit‐lamp adapter was 3D printed and connected with a linear actuator and graphical user interface (GUI) system to control movement and create volumes of 2‐dimensional scans. The ultrasound probe contacted the patient's cornea to perform the scan. The GUI software was designed to acquire and process b‐scan images, which were exported to 3D Slicer and manually annotated. The annotated images were used to render 3D renderings of ophthalmic anatomy using MATLAB and 3D Slicer. Results: The optimal resolution, quality, scan type, and patient comfort were determined through simulations. Higher scan numbers and light contact pressure resulted in sufficient image clarity. Out of 250 completed scans, four 3D ultrasound models were created, depicting diagnoses such as tractional retinal detachment, choroidal hemorrhage, and myopia. These models were compared with traditional imaging methods. Conclusions: The study successfully created 3D ultrasound scans using a novel slit‐lamp‐based system and manual annotation. The accuracy of the models was comparable to other imaging forms and demonstrated greater details. This study represents a significant step toward an accessible point‐of‐care ultrasound system in ophthalmology.

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