Researchers seek scientific evaluation for visual perception of adults with cleft lip, palate

The impact of physical attractiveness on social communication is a truth universally acknowledged. It is not surprising, therefore, that individuals with a cleft lip and palate have experienced social isolation and poor self-esteem. But how people really see faces affected by this anomaly has not been studied. Researchers are now seeking a more scientific evaluation of how people look at faces with a cleft lip and palate through the use of an eye-tracking camera.

The March 2011 issue of The Cleft Palate-Craniofacial Journal reports the findings of a study that analyzed eye movements while participants looked at pictures of faces with and without a unilateral cleft lip and palate. Participants included a group of 33 individuals affected by cleft lip and palate and a control group of 30 unaffected individuals. The results show that participants who have a cleft lip and palate themselves focused on that feature for a longer period of time than those without this facial anomaly.

When looking at a face, the eyes usually fixate on the main features, following a path from one to the next. This occurs in a fixed order, and is known as the scanpath. A typical scanpath has top-down movement, fixing primarily on the eyes, then the nose and mouth. Additionally, it has been documented that viewers will fixate initially and for a longer duration on features that draw on their emotions.

Participants with and without cleft lip and palate showed a quantifiably different scanpath from one another when looking at pictures. Those participants with cleft lip and palate fixated on the nose significantly more often and the eyes significantly less often than those participants without cleft lip and palate. Whether looking at affected or unaffected faces, participants with cleft lip and palate displayed the same scanpath behavior. Both groups of participants looked at pictures of faces with cleft lip and palate longer than they did unaffected faces.

As adults, more than 50% of those with cleft lip and palate have reported dissatisfaction with their facial appearance. Even when surgery to repair the cleft has been performed in infancy with appropriate follow-up therapy, a scar and a distinct asymmetry of the nose remain. Those with a cleft lip and palate would have a stronger emotional connection with these facial features that could explain their different way of viewing a face.