Tracking-Based Interactive Assessment of Saccades, Pursuits, Visual Field, and Contrast Sensitivity in Children With...

Area of Science:

• Ophthalmology
• Neuroscience
• Pediatrics

Background:

• Visual deficits in children with brain injury, such as cerebral/cortical visual impairment (CVI), are challenging to assess due to co-occurring cognitive and communication disabilities.
• Conventional methods often lead to underdiagnosis or rely on subjective evaluations, limiting remediation potential.

Purpose of the Study:

• To introduce and validate a novel eye-movement-based assessment, the "Visual Ladder," for grading visual health in children with brain injuries.
• To reduce reliance on patient attention and communication for visual assessment.

Main Methods:

• The Visual Ladder quantifies spontaneous saccades, pursuits, visual field responsiveness, and spatial visual function using gaze-based tracking.
• The system was tested on fourteen hospitalized children (aged 3-18) with various visual impairments and brain injuries.
• Ten children, including five non-verbal participants, completed multiple assessments over 2 weeks to 9 months.

Main Results:

• The Visual Ladder provided interpretable outcomes for at least three tasks in all ten participants, demonstrating viability in non-communicative children.
• The assessment identified directional biases, nystagmus, visual field asymmetries, and contrast sensitivity deficits.
• Outcomes were interpretable even in non-verbal children, provided eye tracking was feasible.

Conclusions:

• The Visual Ladder offers a rapid, objective method for classifying and grading visual impairments in children with CVI and other cerebral or ocular visual system impairments.
• This approach serves as a crucial diagnostic and prognostic tool, particularly for non-verbal children previously excluded from vision assessments.