Eye Tracking Can Identify Vision, Pupillary Disturbances After Concussion in Teens

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Researchers use a 220-second eye tracking assessment to compare 256 eye tracking metrics among adolescents with and without concussion.

Objective eye tracking can quickly detect vision and pupillary disturbances following concussion in adolescents, according to a study published in Optometry and Vision Science. Researchers used this technology to identify different eye tracking metrics among teenagers with concussions, along with sex-specific differences. 

Researchers compared eye position, saccadic movement, and pupillary dynamics among adolescents with acute post-concussion symptoms (≤28 days since concussion; n=130), adolescents with persistent post-concussion symptoms (>28 days since concussion; n=89), and control group participants (n=180). Patients underwent a 220-second eye tracking assessment in which 256 metrics, including 183 eye position, 60 saccadic movement, and 13 pupillary dynamics metrics were obtained. 

According to the report, 2 eye position metrics were worse in adolescents with concussions compared with control group participants, and 1 metric significantly differed between acute and persistent cases. Participants with a concussion had larger left and right mean, median, minimum, and maximum pupil size than control individuals, and larger differences in mean, median, and variance of left and right pupil size (P <.001 for all).

In total, 12 metrics distinguished girls with a concussion from girls in the control group and 4 were associated with concussion status among boys. A logistic regression model, which included clinical data, demographic data, and transformed eye tracking metrics, performed better in predicting concussion status compared with clinical and demographics data alone, the researchers note. 

“Objective eye tracking technology is capable of quickly identifying vision and pupillary disturbances after concussion, augmenting traditional clinical concussion assessments,” according to the researchers. “Objective eye tracking technology may quickly identify vision disturbances after concussion to allow for earlier recognition, referral, and treatment, potentially reducing long-term effects.”

Study limitations include a limited age range (13-17 years), low number of boys with persistent concussion symptoms, the recruitment of adolescents with concussions from a single-center, and failure to collect iris color. 


Jain D, Arbogast KB, McDonald CC, et al. Eye tracking metrics differences among uninjured adolescents and those with acute or persistent post-concussion symptoms. Optom Vis Sci. Published online August 1, 2022. doi:10.1097/OPX.0000000000001921