The ability to perform quantitative and automated neurological assessment could enhance diagnosis and treatment in the pre-hospital setting, such as during telemedicine or emergency medical services (EMS) encounters. Such a tool could be developed by adapting clinically significant information such as symmetry of eye movement or conjugate eye movement. Here we describe a digital camera-based eye tracking method “NeuroGaze” to capture the symmetry of eye movement while performing neurological eye examination. The proposed method was developed based on detecting the center of the pupil for both eyes from a given video and measuring eye conjugacy by transforming the pupil center coordinates to relative gaze. The method was tested on healthy volunteers while performing three neurological eye examinations <xref ref-type="fn" rid="fn1" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><sup>1</sup></xref> <fn id="fn1" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><label><sup>1</sup></label> The NeuroEye dataset is made available at <uri>https://www.kaggle.com/datasets/mahassan8/neuroeye</uri> </fn> . We also compared our proposed approach to state-of-the-art digital camera-based eye-tracking methods and commercial off-the-shelf (COTS) eye trackers. NeuroGaze outperformed digital camera-based eye tracking methods by reporting a mean Spearman rank-order correlation coefficient of 0.86 for the H-test, 0.87 for the Dot-test, and 0.56 for the OKN-Test, and shows similarity in trends for the relative gaze trajectories with a noticeable offset in the scale of the relative gaze angle compared to COTS eye tracker (see Fig. 1). The study demonstrates that by using a pupil-center-based eye-tracking method, a digital camera can measure clinically relevant information regarding eye movement.
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