The Craig Hospital Eye Evaluation Rating Scale (CHEERS)

Area of Science:

• Neuroscience
• Ophthalmology
• Rehabilitation Medicine

Background:

• Oculomotor deficits are common after moderate to severe traumatic brain injury (TBI).
• Existing scales do not comprehensively assess all types of eye movement abnormalities in TBI.
• The Craig Hospital Eye Evaluation Rating Scale (CHEERS) was developed to systematically evaluate these deficits.

Purpose of the Study:

• To determine the intra- and interrater reliability of the CHEERS scale.
• To assess the scale's ability to detect the presence and degree of five oculomotor abnormalities post-TBI.

Main Methods:

• A reliability study was conducted at Craig Rehabilitation Hospital.
• 11 TBI patients and 9 non-TBI controls were enrolled.
• Eye movements (fixation, smooth pursuit, saccade, convergence, VOR) were recorded and rated twice by two independent raters.

Main Results:

• High intrarater agreement was found for pursuit, saccades, and VOR (Spearman ρ ≥ 0.900).
• Substantial interrater agreement was observed for detecting any oculomotor abnormality (κ = 0.63).
• TBI patients exhibited more abnormal eye movements compared to controls across all measures.

Conclusions:

• The CHEERS scale demonstrates strong reliability for assessing oculomotor deficits in TBI.
• Further research is needed to validate CHEERS for outcome prediction and broader TBI populations.