June 2013
Volume 54, Issue 15
ARVO Annual Meeting Abstract  |   June 2013
Recognition of External Eye Photos: HIPAA Implications
Author Affiliations & Notes
  • Maya Maloney
    Ophthalmology, Mayo Clinic, Rochester, MN
  • Elizabeth Bradley
    Ophthalmology, Mayo Clinic, Rochester, MN
  • Footnotes
    Commercial Relationships Maya Maloney, None; Elizabeth Bradley, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 5352. doi:
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      Maya Maloney, Elizabeth Bradley; Recognition of External Eye Photos: HIPAA Implications. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5352.

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      © ARVO (1962-2015); The Authors (2016-present)

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Clinical photography is essential to education and documentation across medicine, and photographs of the face are especially important in fields such as ophthalmology, otolaryngology and plastic surgery. Since adoption of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule, “full face photographic images and any comparable images” are protected health information because they identify the individual. However, there is no consensus on what constitutes an “identifiable” image. Mayo Clinic’s Privacy Policy recently mandated patient authorization for presentation of partial-face photographs, such as those used in oculoplastic surgery. The purpose of this study was to determine if clinical photographs of eyes are sufficient for identification of the individual.


High-resolution photographs of public figures were cropped to include the eyes from lateral zygoma to lateral zygoma and superior to inferior orbital rim. Each cropped photograph was displayed in random order for 15 seconds to attendees of Mayo Clinic Rochester Department of Ophthalmology Grand Rounds. The full-face photographs were then displayed, again in random order, for 15 seconds per photograph. Participants identified the individual in the cropped and full-face photographs in a fill-in-the-blank format.


There were 23 participants; 12 participants were 20-39 years old, 7 were 40-69 years old, and 4 participants did not disclose their age group. All participants identified a full-face photograph of United States (US) President Barack Obama. Full-face photographs of former US President Bill Clinton and US Secretary of State Hillary Clinton were identified by 22 participants, and 21 participants identified a full-face photograph of talk show host Jay Leno. Partial-face photographs of Bill Clinton and actor/director Clint Eastwood were identified by 12 participants, and 11 participants identified a partial-face photograph of Barack Obama. No participants identified Jay Leno by his partial-face photograph.


Partial-face photographs of public figures are identifiable. This study suggests that patient privacy may be at risk with presentation or publication of cropped photographs.

Keywords: 527 face perception  

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