Aim: Eye tracking tests to measure horizontal and vertical saccades as a proxy for neural deficits associated with traumatic brain injury (TBI) were evaluated in the present study. Methodology: A total of 287 participants reporting either no TBI, mild, moderate or severe TBI participated in a suite of eye tracking tests to measure horizontal and vertical saccadic performance. Results: The horizontal saccades test offered a sensitivity of 0.77 and a specificity of 0.78, similarly the vertical saccades tests offered a sensitivity of 0.64 and a specificity of 0.65. Conclusion: The results indicated that using eye-tracking technology to measure these metrics offers an objective, reliable and quantifiable way of differentiating between individuals with different severities of TBI, and those without a TBI.

Considerable research has documented that successful performance in interceptive tasks (such as return of serve in tennis) is based on the performers' capability to capture appropriate anticipatory information prior to the flight path of the approaching object. Athletes of higher skill tend to fixate on different locations in the playing environment prior to initiation of a skill than their lesser skilled counterparts. The purpose of this study was to examine visual search behaviour strategies of elite (world ranked) tennis players and non-ranked competitive tennis players (n = 43) utilising cluster analysis. The results of hierarchical (Ward's method) and nonhierarchical (k means) cluster analyses revealed three different clusters. The clustering method distinguished visual behaviour of high, middle-and low-ranked players. Specifically, high-ranked players demonstrated longer mean fixation duration and lower variation of visual search than middle-and low-ranked players. In conclusion, the results demonstrated that cluster analysis is a useful tool for detecting and analysing the areas of interest for use in experimental analysis of expertise and to distinguish visual search variables among participants'.

PurposeThe purpose of this study was to determine the reliability of interpupillary distance (IPD) and pupil diameter (PD) measures using an infrared eye tracker and central point stimuli. Validity of the test compared to known clinical tools was determined, and normative data was established against which individuals can measure themselves.MethodsParticipants (416) across various demographics were examined for normative data. Of these, 50 were examined for reliability and validity. Validity for IPD measured the test (RightEye IPD/PD) against the PL850 Pupilometer and the Essilor Digital CRP. For PD, the test was measured against the Rosenbaum Pocket Vision Screener (RPVS). Reliability was analyzed with intraclass correlation coefficients (ICC) between trials with Cronbach's alpha (CA) and the standard error of measurement for each ICC. Convergent validity was investigated by calculating the bivariate correlation coefficient.ResultsReliability results were strong (CA > 0.7) for all measures. High positive significant correlations were found between the RightEye IPD test and the PL850 Pupilometer (P < 0.001) and Essilor Digital CRP (P < 0.001) and for the RightEye PD test and the RPVS (P < 0.001).ConclusionsUsing infrared eye tracking and the RightEye IPD/PD test stimuli, reliable and accurate measures of IPD and PD were found. Results from normative data showed an adequate comparison for people with normal vision development.Translational RelevanceResults revealed a central point of fixation may remove variability in examining PD reliably using infrared eye tracking when consistent environmental and experimental procedures are conducted.

Objective The purpose of this study was to examine the reliability of oculomotor metrics in healthy individuals, to determine the normative values through cluster analysis, and to compare oculomotor metrics by age groups in a suite of digitized eye tracking tests. Design Experimental cross sectional Participants A large sample of 2993 participants completed RightEye tests. Results These tests demonstrated acceptable or higher reliability on 85% of the eye movement metrics and the clustering analysis distinguished 5 distinct age groups. Furthermore, group differences were found between age clusters. Conclusions Overall, the findings represent the reliability of a computerized oculomotor measure and the importance to consider individual and group characteristics for clinical applications as well as applied settings.

Aim: Neural deficits were measured via the eye tracking of vertical smooth pursuit (VSP) as markers of traumatic brain injury (TBI). The present study evaluated the ability of the eye tracking tests to differentiate between different levels of TBI severity and healthy controls. Methodology: Ninety-two individuals divided into four groups (those with mild, moderate or severe TBI and healthy controls) participated in a computerized test of VSP eye movement using a remote eye tracker. Results: The VSP eye tracking test was able to distinguish between severe and moderate levels of TBI but unable to detect differences in the performance of participants with mild TBI and healthy controls. Conclusion: The eye-tracking technology used to measure VSP eye movements is able to provide a timely and objective method of differentiating between individuals with moderate and severe levels of TBI.

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Background: Prior concussion studies have shown that objective neurophysiological measures are sensitive to detecting concussive and subconcussive impairments in youth ice-hockey. These studies monitored brain vital signs at rink-side using a within-subjects design to demonstrate significant changes from pre-season baseline scans. However, practical clinical implementation must overcome inherent challenges related to any dependence on a baseline. This requires establishing the start of normative reference data sets.Methods: The current study collected specific reference data for N = 58 elite, youth, male ice-hockey players and compared these with a general reference dataset from N = 135 of males and females across the lifespan. The elite hockey players were recruited to a select training camp through CAA Hockey, a management agency for players drafted to leagues such as the National Hockey League (NHL). The statistical analysis included a test-retest comparison to establish reliability, and a multivariate analysis of covariance to evaluate differences in brain vital signs between groups with age as a covariate.Findings: Test-retest assessments for brain vital signs evoked potentials showed moderate-to-good reliability (Cronbach’s Alpha &gt; 0.7, Intraclass correlation coefficient &gt; 0.5) in five out of six measures. The multivariate analysis of covariance showed no overall effect for group (p = 0.105), and a significant effect of age as a covariate was observed (p &lt; 0.001). Adjusting for the effect of age, a significant difference was observed in the measure of N100 latency (p = 0.022) between elite hockey players and the heterogeneous control group.Interpretation: The findings support the concept that normative physiological data can be used in brain vital signs evaluation in athletes, and should additionally be stratified for age, skill level, and experience. These can be combined with general norms and/or individual baseline assessments where appropriate and/or possible. The current results allow for brain vital sign evaluation independent of baseline assessment, therefore enabling objective neurophysiological evaluation of concussion management and cognitive performance optimization in ice-hockey.

The size of our pupils changes continuously in response to variations in ambient light levels, a process known as the pupillary light reflex (PLR). The PLR is not a simple reflex as its function is modulated by cognitive brain function and any long-term changes in brain function secondary to injury should cause a change in the parameters of the PLR. We performed a retrospective clinical review of the PLR of our patients using the BrightLamp Reflex iPhone app. The PLR variables of latency, maximum pupil diameter (MaxPD), minimum pupil diameter (MinPD), maximum constriction velocity (MCV), and the 75% recovery time (75% PRT) were associated with significant differences between subjects who had suffered a concussion and those that had not. There were also significant differences in PLR metrics over the life span and between genders and those subjects with and without symptoms. The differences in PLR metrics are modulated not only by concussion history but also by gender and whether or not the person has symptoms associated with a head injury. A concussive injury to the brain is associated with changes in the PLR that persist over the life span, representing biomarkers that might be used in clinical diagnosis, treatment, and decision making.