Uncertainty and worry about concussions and other traumatic brain injuries (TBIs) are a one-two punch; the injury might not get to you, but the stress can wear you down. Professional athletes and their families and parents of student-athletes in particular often face the choice between participation in a beloved sport and protecting brain health. Earlier this year, we wrote about RightEye’s announcement of the Brain Health EyeQ eye-tracking platform that tracks eye movements to differentiate between moderate and severe TBI.

Occulogica introduced the EyeBox in 2017. The EyeBox uses eye-tracking to detect TBI and other abnormalities by measuring elevated intracranial pressure. A study published in the JAMA Journal of Neurosurgery evaluated EyeBox technology with children. In early 2019, the FDA approved EyeBox as a tool to assist with diagnosing concussions in patients 5 through 67 years old.

The current EyeBox technology uses a one-piece machine with a video screen. Patients watch a 220-second cartoon on a screen 15 1/4-inches from their eyes. A chin cup and forehead rest maintain the required distance. The test returns a numeric score using 12 eye movement metrics. The metrics compare eye movement velocity and conjugacy: how well the cranial nerves work together following the action on the screen. The EyeBox score compared well with the standard Acute Concussion Evaluation (ACE) scores.

The ACE evaluation requires patient observation, history, current symptoms, and clinical judgment, but the EyeBox test returns results in minutes with no information about history or symptoms. The EyeBox data not only diagnoses TBI, but the EyeBox AI-software can also indicate injury location based on the performance of specific cranial nerve groups.

Moore’s Law stated the number of transistors on a microchip doubles every two years at half the cost. That observation in 1965 by one of Intel’s co-founders may also apply to AI-based medical technology. EyeBox uses AI to evaluate data obtained by a camera that observes eye movement while the patient watches a video. We won’t be surprised to see EyeBox or similar technology available as a smartphone app within the next few years.