Comparative analysis of spontaneous blinking and the corneal reflex.

Ocular surface health, the cognitive status, psychological health or human neurological disorders, among others, can be assessed by studying eye blinking, which can be differentiated in spontaneous, reflex and voluntary. Its diagnostic potential has provided a great number of works that evaluate their characteristics and variations depending on the subject's condition (sex, tiredness, health, …). The objective of this study was to analyse the differences in blinking kinematics of spontaneous and reflex blinks, distinguishing between direct and consensual reflexes, using a self-developed, non-invasive and image processing-based method. A video-oculography system is proposed using an air jet driven by a syringe to induce reflex and a high-speed camera to record the blinking of both eyes. The light intensity diffused by the eye changes during blinking and peaks when the eyelid closes. Sixty-second sequences were recorded of 25 subjects blinking. Intensity curves were off-line fitted to an exponentially modified Gaussian (EMG) function, whose σ, μ and τ parameters were analysed. A two-way analysis of variance (ANOVA) of these parameters was conducted to test the influence of the subject, the eye and blink type. In the closing phase, direct and consensual corneal reflexes are faster than spontaneous blinking, but there was no significant difference between them, nor between right and left eyes. In the opening phase, the direct corneal reflex was the slowest and significant differences appeared between right and left eyes.