Abstract
Purpose :
Children with brain injury often exhibit cognitive or communicative deficits that impede conventional vision assessment. Ocular abnormalities in such children can often only be assessed with qualitative or low-resolution techniques. We used a novel vision test powered by eye tracking to determine whether spatial asymmetries in eye movements can be reliably quantified in children with brain injury.
Methods :
We measured saccade and pursuit eye movements in 69 children with and 14 children without brain injury (age 3 to 18) during an interactive game-like program called the Visual Ladder, in which the user pops randomly placed/moving virtual bubbles by fixating or tracking them. Mean saccade and pursuit distance for each child were binned into various opposing directional categories to analyze normative asymmetries and identify the children who deviated furthest from the line of best fit (>2 SD) in each comparison.
Results :
Both healthy and brain-injured children exhibited significantly longer horizontal saccades/pursuits than vertical and longer downward saccades than upward (all p < .001; Fig. 1), in agreement with previously established biases. There were no other significant asymmetries. Children with brain injury did not have shorter saccades than healthy children, but did have significantly shorter pursuits (p < .001), which may be partially due to more fragmented pursuit detection from increased noise, and a wider spread for both saccades and pursuits. The 23 outliers detected across the six comparisons (red in Fig. 1) comprised 16 different children with brain injury, revealing how brain injury can manifest in distinct eye movement impairments.
Conclusions :
Our results demonstrate that the Visual Ladder can detect and quantify eye movement asymmetries in children with brain injury, including non-verbal children, and suggest that eye movements may be largely healthy in many such children. Further analysis will be needed to relate the distinct impairments apparent in our data to particular disease diagnoses and outcomes.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.