Virtual reality-based eye tracking throughout typical concussion recovery

Objective: The purpose of this study was to determine the effects of concussion on visual and oculomotor function using a virtual reality-based eye tracking system throughout recovery. Design: A prospective, longitudinal cohort design assessed at the subacute, return-to-activity, and 6-month timepoints was used. Methods: Recently concussed (n = 21; age = 30 ± 14) and healthy control participants (n = 20; age = 29 ± 11) completed visual and oculomotor testing at three timepoints (subacute, return-to-activity, and 6-months) using a virtual reality-based head mounted display eye tracking system sampled at 100 Hz. Symptoms and clinical assessments were collected using the Sport Concussion Assessment Tool-5^th Edition (SCAT-5). Results: No statistically significant visual and oculomotor group differences were observed (p > 0.01), although individuals within the concussion group demonstrated highly variable outcomes at the subacute timepoint. Conclusions: While our findings did not reveal significant group-wide differences in visual and oculomotor function, the high inter-individual variability within the concussion group underscores the need for individualized assessment approaches. The ability of eye-tracking technology to detect subtle, yet potentially clinically relevant impairments at the individual level suggests its potential as a valuable adjunct to symptom-based concussion assessments. Future studies should explore the integration of symptom-based tools, clinical oculomotor assessments, and objective eye-tracking metrics to improve our understanding of concussion-related impairments.