ORIGINAL PAPER Evaluating the growth of eyelid lesions: comparison of clinical evaluation and a software-based model Julie Linden Soto . Ivan Vrcek . Omar Ozgur . Ronald Mancini Received: 20 July 2016 / Accepted: 3 November 2016 Ó Springer Science+Business Media Dordrecht 2016 Abstract Purpose To evaluate the accuracy of clinicians in evaluating the growth of eyelid lesions and to compare the measurements of experienced ophthalmologists to a novel computerized measurement method. Design Prospective, single center, observational study. Methods Six experienced ophthalmologists were asked to measure 3 simulated eyelid lesions using a slit lamp. These lesions were then enlarged, and the same examiners were asked to measure the enlarged lesions without prompting that the lesions had changed. Slit lamp photography of the original lesions and enlarged lesions were analyzed using freely available software from the National Institutes of Health. The results of clinician measurements were compared to the software-generated data. Results Clinician data regarding the growth of the lesions were as follows: -40.9 to ?76.8% for lesion 1, ?29.3 to ?134.4% for lesion 2, and ?148.5 to ?1169.2% for lesion 3. Software-based measurements were as follows: ?53.6, ?100.7, and ?182.2% for lesions 1, 2, and 3, respectively. Conclusions Monitoring growth of eyelid lesions in clinical practice can be challenging. We propose that using computerized software to analyze surface area of concerning eyelid lesions may provide a significant advantage over current clinical practices. Keywords ImageJ Á Eyelid lesions Á Eyelid cancer Introduction Epidemiological studies indicate that 5–10% of all skin cancers occur in the eyelid [1]. Ophthalmologists are frequently tasked with the diagnosis and surveil- lance of neoplastic lesions involving the eyelids. History and physical exam play a pivotal role in directing therapy for suspicious eyelid lesions. His- torical factors including prior cutaneous malignancy, excessive ultra-violet light exposure, and fair skin may predispose an individual to malignancy. Clinicians also rely on various exam findings to guide treatment, including: size, change over time, ulceration, pigment, J. L. Soto Dallas Eye and Ear, Dallas, TX, USA I. Vrcek TOC Eye and Face, Austin, TX, USA O. Ozgur Department of Plastic Surgery, Ophthalmic Plastic and Reconstructive Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA R. Mancini (&) Department of Ophthalmology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 5390-9057, USA e-mail: Ronald.mancini@utsouthwestern.edu 123 Int Ophthalmol DOI 10.1007/s10792-016-0394-1