(1028) Peer Observer Perception of Pediatric Facial Scarring Using Eye-Tracking

Introduction: Facial scarring in children may influence peer perception and social interaction. This study uses eye-tracking technology to evaluate how children visually attend to facial scars at different facial locations and whether observer age affects scar perception.

Methods: This cross-sectional study was conducted in 2025–2026 at a tertiary hospital. Children ages 5–17 years served as peer observers. Standardized photos of four children representing different Fitzpatrick (FP) tones were digitally altered to create six images per face: a scarless control and images with scars placed on different subunits of the face. Participants viewed all images while eye-tracking data were collected. Outcome measures included time to first fixation, total fixation time, and number of fixations on predefined areas of interest. Independent variables included scar presence and location, FP tone, and observer age group. This abstract presents preliminary analyses of results compared to similar data collected when adults viewed the same images.

Results: Sixty-eight participants were enrolled. For cheek scar images, approximately 15% of total fixation time and 15% of total fixations were directed toward the scar across all four faces. The ratio of time spent on the scar compared to non-scar area was statistically significant ( < 0.0001). The latency between first fixation on the face and first fixation on the scar ranged from 0.07 to 0.44 seconds. Fixation patterns were consistent across FP tones. Compared to adults, children took longer to fixate on a scar and each fixation was shorter, but they returned to the scar more frequently.

Conclusions: Children rapidly and repeatedly focus on facial scars, as demonstrated by short time to first fixation and a disproportionate allocation of visual attention to the scar relative to the overall face. They “stare” for shorter periods of time than adults. These findings indicate that facial scarring is a salient perceptual feature for peer observers. Ongoing data collection will allow for larger sample size and age and scar-location specific analyses.