A low-cost robotic oculomotor simulator for assessing eye tracking accuracy in health and disease

Eye tracking accuracy is affected in individuals with vision and oculomotor deficits, impeding our ability to answer important scientific and clinical questions about these disorders. It is difficult to disambiguate decreases in eye movement accuracy and changes in accuracy of the eye tracking itself. We propose the EyeRobot-a low-cost, robotic oculomotor simulator capable of emulating healthy and compromised eye movements to provide ground truth assessment of eye tracker performance, and how different aspects of oculomotor deficits might affect tracking accuracy and performance. The device can operate with eccentric optical axes or large deviations between the eyes, as well as simulate oculomotor pathologies, such as large fixational instabilities. We find that our design can provide accurate eye movements for both central and eccentric viewing conditions, which can be tracked by using a head-mounted eye tracker, Pupil Core. As proof of concept, we examine the effects of eccentric fixation on calibration accuracy and find that Pupil Core's existing eye tracking algorithm is robust to large fixation offsets. In addition, we demonstrate that the EyeRobot can simulate realistic eye movements like saccades and smooth pursuit that can be tracked using video-based eye tracking. These tests suggest that the EyeRobot, an easy to build and flexible tool, can aid with eye tracking validation and future algorithm development in healthy and compromised vision.

Effectiveness of a time to fixate for fitness to drive evaluation in neurological patients

We present a method to automatically calculate time to fixate (TTF) from the eye-tracker data in subjects with neurological impairment using a driving simulator. TTF presents the time interval for a person to notice the stimulus from its first occurrence. Precisely, we measured the time since the children started to cross the street until the drivers directed their look to the children. From 108 neurological patients recruited for the study, the analysis of TTF was performed in 56 patients to assess fit-, unfit-, and conditionally-fit-to-drive patients. The results showed that the proposed method based on the YOLO (you only look once) object detector is efficient for computing TTFs from the eye-tracker data. We obtained discriminative results for fit-to-drive patients by application of Tukey's honest significant difference post hoc test (p < 0.01), while no difference was observed between conditionally-fit and unfit-to-drive groups (p = 0.542). Moreover, we show that time-to-collision (TTC), initial gaze distance (IGD) from pedestrians, and speed at the hazard onset did not influence the result, while the only significant interaction is among fitness, IGD, and TTC on TTF. Obtained TTFs are also compared with the perception response times (PRT) calculated independently from eye-tracker data and YOLO. Although we reached statistically significant results that speak in favor of possible method application for assessment of fitness to drive, we provide detailed directions for future driving simulation-based evaluation and propose processing workflow to secure reliable TTF calculation and its possible application in for example psychology and neuroscience.

Developmental changes in visual-cognitive and attentional functions in infancy

BACKGROUND

Identifying developmental changes in visual-cognitive and attentional functions during infancy may lead to early diagnosis of neurodevelopmental disorders such as ASD and ADHD.

AIMS

To clarify the developmental changes in visual-cognitive and attentional functions during infancy (3-36 months of age).

STUDY DESIGN

Cross-sectional study.

SUBJECTS

We included 23, 24, 31, and 26 participants aged 3, 9, 18, and 36 months, respectively (full-term births). Fifteen children who cried intensely or whose data could not be accurately recorded were excluded.

OUTCOME MEASURES

Three activities were given to each child while they were seated in front of a gaze-tracking device to evaluate re-gaze, motion transparency, and color-motion integration. We analyzed whether the child's attention shifted to the new stimulus in their peripheral vision in the re-gaze task. In the motion transparency and color-motion integration tasks, two images were presented simultaneously on the screen. In the motion transparency task, participants preferred random dots moving in opposite directions; in the color-motion task, they preferred subjective contours from apparent motion stimuli consisting of random red and green dots with different luminance.

RESULTS

In the re-gaze task, fewer 3-month-olds gazed at the new target than other age groups participants. All ages showed preference for target stimuli in the motion transparency task, but 3-month-olds showed significantly lower preference in the color-motion integration task.

CONCLUSION

These tasks may be useful for measuring visual-cognitive and attentional functions in infants.

Assessing the impact of driver advisory systems on train driver workload, attention allocation and safety performance

Netherlands Railways has developed driver advisory systems (DAS) to provide the train driver with route context information and coasting advice in order to benefit punctuality and energy efficiency. However, the impact of these DAS on human factors aspects and safety performance is unclear. The current study assesses the impact of two DAS levels (route context information and coasting advice) on mental workload, attention allocation and safety performance, using eye tracking, a subjective mental workload rating scale (RSME) and simulator data. The overall findings suggest that the application of DAS levels has no negative impact on safety performance and attention allocation towards the trackside compared to a control condition with static timetable information. Furthermore, safety performance benefits significantly from DAS with route context information. DAS were originally developed to benefit punctuality and energy efficiency goals. This study implicates that DAS can also benefit safety performance. The current study found that DAS could decrease workload when the functionalities meet the requirements of the situation. The possible presence of mental underload and its effect on driving performance should be taken into consideration when implementing DAS. It is essential in the development of DAS that it meaningfully enriches the train driving task in stead of simply increasing mental workload.

Small head movements increase and colour noise in data from five video-based P-CR eye trackers

We empirically investigate the role of small, almost imperceptible balance and breathing movements of the head on the level and colour of noise in data from five commercial video-based P-CR eye trackers. By comparing noise from recordings with completely static artificial eyes to noise from recordings where the artificial eyes are worn by humans, we show that very small head movements increase levels and colouring of the noise in data recorded from all five eye trackers in this study. This increase of noise levels is seen not only in the gaze signal, but also in the P and CR signals of the eye trackers that provide these camera image features. The P and CR signals of the SMI eye trackers correlate strongly during small head movements, but less so or not at all when the head is completely still, indicating that head movements are registered by the P and CR images in the eye camera. By recording with artificial eyes, we can also show that the pupil size artefact has no major role in increasing and colouring noise. Our findings add to and replicate the observation by Niehorster et al., (2021) that lowpass filters in video-based P-CR eye trackers colour the data. Irrespective of source, filters or head movements, coloured noise can be confused for oculomotor drift. We also find that usage of the default head restriction in the EyeLink 1000+, the EyeLink II and the HiSpeed240 result in noisier data compared to less head restriction. Researchers investigating data quality in eye trackers should consider not using the Gen 2 artificial eye from SR Research / EyeLink. Data recorded with this artificial eye are much noisier than data recorded with other artificial eyes, on average 2.2-14.5 times worse for the five eye trackers.

Wheelchair Driving Strategies: a comparison between standard joystick and gaze-based control

This paper aims to evaluate and compare the driving performances achieved with a power wheelchair using a standard joystick versus a novel gaze-based technology. The gaze-based interface, called RoboEYE, involves a novel paradigm of computer interaction that handles the receipt of information from an eye tracker, using it as a continuous input for wheelchair navigation. A pool of 36 subjects has tested both technologies in a circuit designed considering the Wheelchair Skill Test. The experimental analysis involved evaluations of specific metrics of motion and the submission of questionnaires to collect required information about perceived feelings and mental workload. The joystick proved to be the best driving interface. It turned out to be more accurate and efficient than the gaze-based solution. However, the latter achieved only small differences in driving kinematics. These differences can be considered negligible from an operational point of view, offering a driving experience similar to that achievable with the joystick. Testers reported no particular stress, fatigue, or frustration when switching from one interface to another. These elements suggest that the proposed gaze-based solution is an appropriate alternative for a technology transition driven by a pathological change in the user's condition.

Evaluation of saccadic velocity in patients with orbital floor fracture before and after surgery

Saccadic eye movement plays an important role in the rapid movement of the eyes to visual targets; however, it has not been fully investigated in patients with an orbital floor fracture. Thus, this study investigated saccadic eye movement before and after surgery in patients with an orbital floor fracture. The saccadic peak velocity (PV) was recorded using an eye-tracking device before and after surgery in nine eyes of nine patients with an orbital floor fracture. The type of fracture was a depressed fragment fracture in all cases, and there was no trap-door fracture. Ocular motility and diplopia were evaluated by the Hess area ratio (HAR%) and the scoring of binocular single vision (BSV). The preoperative HAR% and those at 1 month post-surgery and the final post-surgery observation were 62 ± 6%, 83 ± 11%, and 91 ± 8%, respectively. The preoperative, 1 month post-surgery, and final observation post-surgery BSV scores were 34 ± 18, 46 ± 8, and 50 ± 8 points, respectively. The postoperative HAR% and BSV were significantly improved at the final post-surgery observation (p < .05 each). The saccadic PVs of adduction, abduction, and downgaze before and after surgery were not significantly different in both the non-injured eyes and the injured eyes. However, the upgaze saccadic PVs at 1 month and the final post-surgery observation in the injured eyes were significantly increased (p < .05 each). The saccadic PV may be useful to evaluate detailed and precise extraocular muscle function before and after surgery for orbital floor fractures.

Quantification of smooth pursuit dysfunction in multiple sclerosis

BACKGROUND

Smooth pursuit dysfunction is common in MS, but rarely quantified and may be missed on exam.

METHODS

NeuroFitONE™ smooth pursuit performance measures were compared between MS (n = 20) and healthy control (n = 19) participants.

RESULTS

Compared to controls, MS patients had lower proportion of smooth pursuit (0.63 vs. 0.73; p = 0.047), increased directional (10.1 vs. 8°; p = 0.014) and speed noise (4.3 vs. 3.1°/sec; p = 0.021) and reduced initiation acceleration (96.83 vs. 115.33°/sec²; p = 0.061). Significant univariate correlations with clinical scores (EDSS, T25-FW) were observed.

CONCLUSION

Smooth pursuit dysfunction in MS can be readily quantified and distinguishes MS eyes from healthy controls.

Do low birth weight infants not see eyes? Face recognition in infancy

BACKGROUND

Progress in neonatal medicine has dramatically improved the survival rate of preterm births, but the evidence suggests that these low-birth weight infants (LBWIs) go on to develop pervasive development disorders and attention deficit hyperactivity disorder (ADHD) at greater rates than the general population. Children with neurodevelopmental disorders are known to suffer from deficits in visual cognition, such as in face perception and attentional functions, the characteristics of which already manifest in early infancy.

PURPOSE

This study aimed to investigate visual cognition in LBWIs during infancy.

SUBJECTS

20 LBWIs and 20 normal-birth-weight infants (NBWIs: control) of age 9-10 months (corrected age was used for LBWIs).

METHOD

Children were held seated in front of an eye tracking system by a parent, and presented with facial photos as visual stimuli. During the familiarization phase, the child was presented with two images of the same human face (familiarization stimulus) on the left and right side of a display screen (5 × 10 s trials). Next, during the test phase, the child was presented with the same image on one side of the screen, and a photo of a different person's face (novel stimulus) on the other (2 × 5 s trials). Gaze behavior was assessed in terms of the total time spent looking at either facial stimulus, and specifically at the eyes of the stimuli, as well as the number of attentional shifts between stimuli, and novelty preference.

RESULTS/DISCUSSION

LBWIs spent significant less time looking at facial stimuli overall, and less time at the eye region, than NBWIs. These findings seem to evidence developmental differences in functions related to visual cognition.

Eye movement biomarkers allow for the definition of phenotypes in Gaucher Disease

BACKGROUND

Neurological forms of Gaucher disease, the inherited disorder of β-Glucosylceramidase caused by bi-allelic variants in GBA1, is a progressive disorder which lacks a disease-modifying therapy. Systemic manifestations of disease are effectively treated with enzyme replacement therapy, however, molecules which cross the blood-brain barrier are still under investigation. Clinical trials of such therapeutics require robust, reproducible clinical endpoints to demonstrate efficacy and clear phenotypic definitions to identify suitable patients for inclusion in trials. The single consistent clinical feature in all patients with neuronopathic disease is the presence of a supranuclear saccadic gaze palsy, in the presence of Gaucher disease this finding serves as diagnostic of 'type 3' Gaucher disease.

METHODS

We undertook a study to evaluate saccadic eye movements in Gaucher patients and to assess the role of the EyeSeeCam in measuring saccades. The EyeSeeCam is a video-oculography device which was used to run a protocol of saccade measures. We studied 39 patients with non-neurological Gaucher disease (type 1), 21 patients with type 3 (neurological) disease and a series of 35 healthy controls. Mean saccade parameters were compared across disease subgroups.

RESULTS

We confirmed the saccadic abnormality in patients with type 3 Gaucher disease and identified an unexpected subgroup of patients with type 1 Gaucher disease who demonstrated significant saccade parameter abnormalities. These patients also showed subtle neurological findings and shared a GBA1 variant.

CONCLUSIONS

This striking novel finding of a potentially attenuated type 3 Gaucher phenotype associated with a specific GBA1 variant and detectable saccadic abnormality prompts review of current disease classification. Further, this finding highlights the broad spectrum of neuronopathic Gaucher phenotypes relevant when designing inclusion criteria for clinical trials.

Development of an Eye-Tracking Image Manipulation System for Angiography: A Comparative Study

RATIONALE AND OBJECTIVES

Appropriate image manipulation of angiographic image display systems during interventional radiology is performed by radiological technologists and/or nurses given instructions from radiologists. However, appropriate images might not be displayed because of communication errors. Therefore, we developed a manipulation system that uses an eye tracker. The study aimed to determine if an angiographic image display system can be manipulated as well by using an eye tracker as by using a mouse.

MATERIALS AND METHODS

An angiographic image display system using an eye tracker to calculate the gaze position on the screen and state of fixation was developed. Fourteen radiological technologists participated in an observer study by manipulating 10 images for each of 5 typical cases frequently performed in angiography, such as renal tumor, cerebral aneurysm, liver tumor, uterine bleeding, and hypersplenism. We measured the time from the start to the end of manipulating a series of images required when using the eye tracker and the conventional mouse. In this study, the statistical processing was done using Excel and R and R studio.

RESULTS

The average time required for all observers for completing all cases was significantly shorter when using the eye tracker than when using the mouse (10.4 ± 2.1 s and 16.9 ± 2.6 s, respectively; p< 0.001 by paired t test).

CONCLUSION

Radiologists were able to manipulate an angiographic image display system directly by using the newly developed eye tracker system without touching contact devices, such as a mouse or angiography console. Therefore, communication error could be avoided.

Development and validation of a high-speed video system for measuring saccadic eye movement

Laboratory-based retroreflective and magnetic scleral search-coil technologies are the current standards for collecting saccadometric data, but such equipment is costly and cumbersome. We have validated a novel, portable, high-speed video camera-based system (Exilim EX-FH20, Casio, Tokyo, Japan) for measuring saccade reaction time (RT) and error rate in a well-lit environment. This system would enable measurements of pro- and antisaccades in athletes, which is important because antisaccade metrics provide a valid tool for concussion diagnosis and determining an athlete's safe return to play. A total of 529 trials collected from 15 participants were used to compare saccade RT and error rate measurements of the high-speed camera system to a retroreflective video-based eye tracker (Eye-Trac 6: Applied Sciences Laboratories, Bedford, MA). Bland-Altman analysis revealed that the RT measurements made by the high-speed video system were 11 ms slower than those made by the retroreflective system. Error rate measurements were identical between the two systems. An excellent degree of reliability was found between the system measurements and in the ratings of independent researchers examining the video data. A strong association (r = .97) between the RTs determined via the retroreflective and high-speed camera systems was observed across all trials. Our high-speed camera system is portable and easily set up, does not require extensive equipment calibration, and can be used in a well-lit environment. Accordingly, the camera-based capture of saccadometric data may provide a valuable tool for neurological assessment following a concussive event and for the continued monitoring of recovery.

Using Eye Tracking to Assess Gaze Concentration in Meditation

An important component of Heart Chan Meditation is gaze concentration training. Here, we determine whether eye tracking can be used to assess gaze concentration ability. Study participants (n = 306) were requested to focus their gaze on the innermost of three concentric circles for 1 min while their eye movements were recorded. Results suggest that participants with high scores on gaze concentration accuracy and precision had lower systolic blood pressure and higher sleep quality, suggesting that eye tracking may be effective to assess and train gaze concentration within Heart Chan Meditation.

A novel fiber Bragg grating system for eye tracking

Eye movement evaluation is vital for diagnosis of various ophthalmological and neurological disorders. The present study proposes a novel, noninvasive, wearable device to acquire the eye movement based on a Fiber Bragg Grating (FBG) Sensor. The proposed Fiber Bragg Grating Eye Tracker (FBGET) can capture the displacement of the eyeball during its movements in the form of strain variations on a cantilever. The muscular displacement generated by the eyeball over the lower eyelid, by its swiveling action while moving the gaze on a target object, is converted into strain variations on a cantilever. The developed FBGET is investigated for dynamic tracking of the eye-gaze movement for various actions of the eye such as fixations, saccades and main sequence. This approach was validated by recording the eye movement using the developed FBGET as well as conventional camera-based eye tracker methodology simultaneously. The experimental results demonstrate the feasibility and the real-time applicability of the proposed FBGET as an eye tracking device. In conclusion, the present study illustrates a novel methodology involving displacement of lower eyelid for eye tracking application along with the employment of FBG sensors to carry out the same. The proposed FBGET can be utilized in both clinical and hospital environment for diagnostic purposes owing to its advantages of wear-ability and ease of implementation making it a point of care device.

Dual System for Enhancing Cognitive Abilities of Children with ADHD Using Leap Motion and eye-Tracking Technologies

Attention Deficit Hyperactivity Disorder (ADHD) is a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that affects with development or functioning. It affects 3-5% of all American and European children. The objective of this paper is to develop and test a dual system for the rehabilitation of cognitive functions in children with ADHD. A technological platform has been developed using the ". NET framework", which makes use of two physiological sensors, -an eye-tracker and a hand gesture recognition sensor- in order to provide children with the opportunity to develop their learning and attention skills. The two physiological sensors we utilized for the development are the Tobii X1 Light Eye Tracker and the Leap Motion. SUS and QUIS questionnaires have been carried out. 19 users tested the system and the average age was 10.88 years (SD = 3.14). The results obtained after tests were performed were quite positive and hopeful. The learning of the users caused by the system and the interfaces item got a high punctuation with a mean of 7.34 (SD = 1.06) for SUS questionnaire and 7.73 (SD = 0.6) for QUIS questionnaire. We didn't find differences between boys and girls. The developed multimodal rehabilitation system can help to children with attention deficit and learning issues. Moreover, the teachers may utilize this system to track the progression of their students and see their behavior.

An eye-tracker controlled cognitive battery: overcoming verbal-motor limitations in ALS

We assessed language, attention, executive, and social cognition abilities in a sample of patients with Amyotrophic Lateral Sclerosis (ALS) by means of a recently developed cognitive battery based on oculomotor control with eye-tracking (ET) technology. Twenty-one ALS patients and 21 age- and education-matched healthy subjects underwent the ET-based cognitive assessment, together with the standard cognitive screening tools [Frontal Assessment Battery (FAB); Montreal Cognitive Assessment (MoCA); and Digit Sequencing Task]. Psychological measures of anxiety (State-Trait Anxiety Inventory-Y) and depression (Beck Depression Inventory) were also collected, and an ET usability questionnaire was administered. For patients, clinical and respiratory examinations were also performed, together with behavioural assessment (Frontal Behavioural Inventory). The developed battery discriminated among patients and controls with regard to measures of verbal fluency, frontal abilities, and social cognition. Measures of diagnostic utility confirmed a higher diagnostic accuracy of such ET-based tests with respect to FAB; similar diagnostic accuracy emerged when comparing them to the other standard cognitive tools (MoCA, WM). Usability ratings about the ET tests were comparable among the two groups. The ET-based neuropsychological battery demonstrated good levels of diagnostic accuracy and usability in a clinical population of non-demented ALS patients, compared to matched healthy controls. Future studies will be aimed at further investigate validity and usability components by recruiting larger sample of patients, both in moderate-to-severe stages of the disease and affected by more severe cognitive impairment.