Search Results (61)

To compare oculomotor profiles among children wearing orthokeratology, defocus spectacle, and diffusion optics technology lenses in a routine pediatric myopia management setting. This real-world observational study included children who had worn one of the three lens types for approximately one year and had available eye tracking data. Lens type was selected during routine clinical care rather than assigned by the investigators. Oculomotor parameters were compared among lens groups using Kruskal–Wallis tests with false discovery rate correction. One-year spherical equivalent change was examined only in the defocus spectacle and diffusion optics technology groups. Adjusted and exploratory analyses included age, sex, baseline spherical equivalent, baseline axial length, axial elongation, and parental education categories. A total of 134 children were analyzed, including 46 in the orthokeratology group, 49 in the defocus spectacle group, and 39 in the diffusion optics technology group. Significant group differences were observed for microsaccade frequency (FDR adjusted p = 0.00099), peak velocity (FDR adjusted p = 0.00099), latency (FDR adjusted p = 0.00395), fixation disparity (FDR adjusted p = 0.00395), and conjugacy (FDR adjusted p = 0.0274). Saccade frequency and saccade amplitude did not differ significantly. One-year spherical equivalent change did not differ significantly between the defocus spectacle group and the diffusion optics technology group (−0.27 ± 0.43 D vs. −0.34 ± 0.36 D, p = 0.312). No statistically significant correlation was observed between spherical equivalent change and microsaccade frequency in the two spectacle lens groups (Spearman r = −0.231, p = 0.069). Parental education categories showed no consistent association with oculomotor parameters after correction for multiple comparisons. Children wearing different myopia control lenses showed selective differences in oculomotor profiles. Refractive change in the two spectacle lens groups was similar, and the observed oculomotor differences should not be interpreted as direct indicators of myopia control efficacy. Eye tracking may provide complementary information about visual behavior and lens adaptation, but prospective studies with age-balanced designs and longitudinal refractive and axial length outcomes are needed. Full article

Background/Objectives: Eating disorders are increasingly conceptualized as information-processing disorders characterized by attentional biases toward food-related stimuli. However, whether such biases are already detectable in subclinical, non-treatment-seeking populations remains unclear. This study examined whether subclinical eating pathology, assessed with the Eating Attitudes Test-26 (EAT-26), is associated with distinct patterns of visual attention toward high- and low-calorie food images in university students. Methods: In this cross-sectional observational study featuring an experimental eye-tracking task, 89 university students completed the EAT-26 and a visual task displaying paired high- and low-calorie food images alongside neutral controls. Oculomotor metrics included first fixation duration (FFD), fixation count (FC), and average fixation duration (AFD). Data were evaluated using EAT-26 threshold-based group stratification (lower-risk vs. risky eating behavior) and Spearman rank correlation analyses. Results: Global EAT-26 scores showed a significant correlation with a directional attentional bias index (rho = 0.29, p = 0.006). The Dieting subscale demonstrated no significant relationships with any oculomotor metrics. Conversely, Oral Control scores were significantly negatively correlated with the directional attentional bias index (rho = −0.27, p = 0.009) and positively tracked with low-calorie fixation counts (rho = 0.30, p = 0.004). Bulimia subscale scores showed a moderate positive correlation with the directional attentional bias index (rho = 0.26, p = 0.013), characterized by a significant decrease in low-calorie fixation counts (rho = −0.32, p = 0.002) and a strong increase in high-calorie fixation counts (rho = 0.36, p < 0.001) during sustained viewing. Conclusions: Subclinical eating pathology tendencies are associated with distinct implicit attentional profiles regarding food caloric density during sustained cognitive evaluation. Oral control drives visual prioritization of low-calorie stimuli to maintain inhibitory control, whereas bulimic tendencies reflect prolonged visual preoccupation with high-calorie reward cues. Eye-tracking represents a promising non-invasive research tool for exploring early cognitive correlates of eating-disorder risk. Full article

Background/Objectives: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease increasingly recognized for extra-motor manifestations, including cognitive dysfunction involving frontal cortical systems. Conventional clinical assessments are primarily behavioral and may not capture subtle alterations in the neural systems that support cognitive performance. This pilot study examined whether wearable functional near-infrared spectroscopy (fNIRS) could detect task-evoked prefrontal hemodynamic differences during the King-Devick Task (KDT), a rapid oculomotor number-naming task that engages visual scanning, attention, processing speed, and verbal response production. Methods: Sixteen participants, including seven individuals with ALS and nine age-matched healthy controls (HC), completed four progressively difficult KDT conditions while prefrontal cortical activity was recorded. Results: As task difficulty increased, response times became slower across participants, while accuracy remained preserved and behavioral performance did not differ significantly between groups. Prefrontal oxygenated hemoglobin (HbO) responses increased with task difficulty across all prefrontal optodes, supporting task-evoked cortical engagement. In contrast, deoxygenated hemoglobin (HbR) responses showed a group-specific pattern in the left dorsolateral prefrontal cortex: individuals with ALS demonstrated progressively increasing HbR responses across difficulty conditions, whereas HC showed relatively stable responses, with group differences emerging at higher difficulty levels. Conclusions: These findings suggest a dissociation between preserved behavioral performance and altered prefrontal hemodynamic regulation in ALS. The observed HbR pattern may reflect differences in cortical recruitment, neurovascular coupling, oxygen extraction, vascular responsiveness, or the efficiency of cortical resource allocation during increasing cognitive-motor demands. Wearable fNIRS may therefore complement behavioral assessments by revealing task-evoked neural alterations that are not evident from performance measures alone. Full article

Reading speed, a core indicator of reading performance, requires efficient oculomotor behavior. While well-documented in adults, the contribution of eye movements to children’s silent reading speed and grade-related changes remain underspecified. Furthermore, the distributional properties of fixation durations have rarely been examined in children. This study investigates how changes in eye-movement parameters associate with individual differences in children’s silent reading speed. The eye movements of 194 typically developing Greek-speaking students (Grades 3–6) were recorded during silent reading of short passages. An Ex-Gaussian distributional analysis was applied to fixation durations, alongside traditional measures of mean fixation number, fixation duration, and saccade amplitude. Language and cognitive abilities were also evaluated. Silent reading speed increased with grade, driven by fewer and shorter fixations, and longer saccades. After accounting for age, vocabulary and cognitive measures, eye-movement parameters increased the explained variance in silent reading speed to 80% (adjusted R² = 0.800) in the full sample (N = 194). The Ex-Gaussian parameter τ was an independent predictor, distinct from mean fixation duration. Finally, age significantly moderated the association between forward fixations and silent reading speed. These findings indicate that oculomotor behavior is independently linked to children’s silent reading speed across primary school years, as captured both by conventional and distributional oculomotor parameters. Full article

Deaf children who acquire a signed language at home and at school prior to learning to read are a unique group of developing bilinguals. They are first-language users of a signed language (e.g., American Sign Language; ASL) and second-language users of the written form of the ambient spoken language (e.g., English). Because signed languages do not possess orthographies that are widely used, deaf readers typically read in their second language. This profile stands in contrast to hearing bilingual readers, who read in their first language and, sometimes, their second language. In studies of child readers, vocabulary knowledge is a strong predictor of reading comprehension for both monolinguals and bilinguals. We combine the unique linguistic backgrounds of young signing deaf readers with what is known about vocabulary knowledge and reading, guided by the following research question: Does signed (L1) and spoken (L2) vocabulary knowledge predict reading (eye-gaze) behaviors of deaf children when reading in their L2? We present results from an exploratory pilot eye-tracking study of nine deaf ASL-English bilingual children ages 9–11, examining whether ASL and English vocabulary knowledge predict different aspects of the reading paradigm. Results suggest that ASL vocabulary predicts where-decisions and measures of oculomotor control such as skipping and regressions, while English vocabulary predicts when-decisions and first-pass durations. We suggest these results from this small-scale study provide initial support for the language interdependence hypothesis because deaf child signers’ first-language vocabulary knowledge predicts some of the variance in second-language reading performance. Full article

Sport-related concussion (SRC) rehabilitation has advanced toward active, multidomain management, yet recovery may still be judged largely through symptom resolution and broad clinical indicators that may not fully capture persistent functional deficits. Emerging evidence suggests subtle disturbances in postural control, gait, and sensorimotor coordination may persist beyond apparent clinical recovery, raising the possibility that unresolved asymmetries represent an underrecognized dimension of dysfunction. This Viewpoint proposes symmetry restoration as a potential rehabilitative construct in SRC management and explores how biofeedback-guided approaches may provide a conceptual framework for identifying, monitoring, and retraining symmetry-related deficits. Drawing from concussion research, motor control theory, rehabilitation science, and biofeedback applications, this article discusses postural and movement asymmetries as possible markers of incomplete recovery, examines visual, wearable, neuromuscular, and auditory biofeedback strategies as potential mechanisms for symmetry-informed rehabilitation, and outlines clinical implications and future research priorities. Rather than proposing symmetry as a stand-alone determinant of recovery, this Viewpoint advances the conceptual proposition that symmetry-oriented approach may complement existing multidomain models by serving as an additional layer of functional assessment alongside symptom reporting, neurocognitive evaluation, vestibular and oculomotor examination, exertional testing, and routine clinical assessment. Within this framework, symmetry-related measures are envisioned not as independent clearance criteria, but as potentially informative indicators of residual sensorimotor function that may help guide rehabilitation progression and contribute to more functionally informed return-to-sport decision making through adjunctive measures such as center-of-pressure behavior, center-of-mass displacement, gait symmetry, stance and swing time asymmetry, limb-loading patterns, interlimb coordination, and muscle activation symmetry. Full article

Eye-tracking technologies enable precise measurement of eye movements and are widely used in visual behavior analysis and biomedical engineering applications. Oculomotor parameters, such as fixation duration, saccades, and pupil dilation, are influenced by both visual stimulus characteristics and emotional state; however, the relationships between these factors are difficult to model in a coherent manner. In this context, this paper proposes a model for describing the influence of wavelength and emotional parameters on eye movements. The model expresses oculomotor parameters as functions of the input variables, using simplified relationships that allow both interpretability and practical implementation. To analyze the model, a MATLAB-based application was developed, enabling the simulation of oculomotor behavior under different scenarios. The obtained results highlight variations in the analyzed parameters depending on the input conditions and support the applicability of the model in biomedical monitoring and visual behavior assessment. Full article

Background: The vestibular system has traditionally been interpreted within a reflex-based framework, mainly centered on gaze stabilization, vestibulo-ocular reflex pathways, and peripheral vestibular deficits. This model remains essential, but it is insufficient to explain the full spectrum of postural, perceptual, visual-motion, and self-motion complaints observed in contemporary clinical otoneurology. Objective: This conceptual narrative review examines selected representative works by Kathleen E. Cullen as landmarks in a broader transition from reflex physiology to predictive, multimodal, context-dependent, body-centered self-motion control. Methods: This is not a systematic or bibliometric review. Papers were selected because they mark distinct conceptual steps in Cullen’s work: neural encoding of self-motion, peripheral and central coding strategies, multimodal integration, active versus passive self-motion, reafference suppression, body-centered encoding, proprioceptive prediction, vestibular cerebellar internal models, sensory reweighting, and clinical translation. Synthesis: Angelaki and Cullen’s 2008 synthesis and Cullen’s subsequent work demonstrate that vestibular processing is inherently multimodal from the earliest central stages and that neural representations of self-motion depend on behavioral context. Vestibular nuclei, visual-vestibular networks, and vestibular cerebellar circuits integrate labyrinthine signals with optic flow, proprioceptive, oculomotor, motor, cerebellar, cortical, and contextual information. This architecture enables the brain to distinguish expected from unexpected motion, suppress predictable vestibular reafference during voluntary action, compute internal estimates of body motion, adapt to altered sensory reliability, and reweight sensory inputs according to task demands. Conclusions: The clinical relevance of this trajectory is substantial. Patients may show preserved high-acceleration vestibulo-ocular reflex responses while experiencing persistent instability, visually induced dizziness, defective self-motion perception, or abnormal sustained vestibular processing. Such dissociations are not paradoxical when the vestibular system is understood as a predictive, distributed, body-centered control system. Cullen’s long lesson offers a neurophysiological foundation for a modern vestibular grammar in which clinical findings are interpreted across the reflexive, perceptual, postural, visual-vestibular, sustained, and predictive domains. Full article

Atypical visual attention to aversive or threatening stimuli is a clinically relevant feature of aggressive behavior. However, the developmental dissociation between sustained visual allocation and early orienting remains unclear. This study examined the temporal dynamics of visual attentional biases in a sample of 119 children and adolescents (51 males, 68 females), clinically and behaviorally categorized into aggressive and non-aggressive cohorts. Using a free-viewing paradigm with standardized emotional stimulus pairs selected from the International Affective Picture System (IAPS), eye-tracking analysis focused on first-fixation direction and dwell time. Inferential analyses were conducted using Linear Mixed-Effect Models (LMM) and Generalized Linear Mixed-Effects Models (GLMM). The linear model revealed a significant main effect of behavioral condition: individuals with aggressive traits, regardless of their stage of development, showed greater sustained visual allocation toward negative stimuli. In contrast, the GLMM for first-fixation direction identified a significant age-by-condition interaction, indicating that early orienting differences were more clearly expressed in the aggressive adolescent cohort. These findings suggest that sustained visual preference for negative content may represent a relatively stable correlate of aggressive traits, whereas early orienting differences may vary across developmental stages. Together, these two temporal eye-tracking measures may provide complementary information for future computational approaches to aggression screening. In conclusion, these two temporal oculomotor dimensions may provide a useful feature space for future machine-learning pipelines and may serve as complementary candidate markers for comparing computational predictions against clinically established ground truth in aggression screening research. Full article

Context: Sport-related concussion (SRC) management has evolved substantially over the past 25 years. Early paradigms emphasized prolonged physical and cognitive rest; however, growing evidence has demonstrated that recovery following SRC is multidimensional and influenced by interacting neurological, vestibular, autonomic, cervical, cognitive, and psychological systems. Consequently, contemporary clinical practice has shifted toward active, multifaceted rehabilitation approaches. Objective: We aimed to synthesize and contextualize the evidence supporting a multifaceted approach to sport-related concussion management from 2000 through 2025, with emphasis on implications for athletic training practice. Data Sources: A structured literature search was conducted using PubMed, SPORTDiscus, CINAHL, and Web of Science to identify peer-reviewed publications related to SRC evaluation, management, and rehabilitation. Study Selection: Studies published between 1 January 2000, and 31 December 2025 involving human participants with sport-related concussion or sport-like mechanisms of mild traumatic brain injury were included. Evidence from randomized controlled trials, cohort studies, systematic and narrative reviews, and major consensus or position statements was considered. Data Extraction: Relevant studies were reviewed and synthesized across key domains of SRC management, including aerobic exercise, vestibular and oculomotor rehabilitation, cervical spine management, multimodal and profile-based rehabilitation, return-to-learn strategies, psychological and behavioral health considerations, and implementation patterns within athletic training settings. Results: A total of 182 publications contributed evidence to one or more components of multifaceted SRC management. Across domains, evidence supports early, symptom-limited aerobic exercise; targeted vestibular and cervical rehabilitation; structured return-to-learn planning; and the integration of psychological support. Multimodal rehabilitation and profile-based clinical categorization approaches were associated with shorter recovery timelines and improved functional outcomes compared with rest-only strategies. Despite strong evidence, implementation variability persists across athletic training settings. Conclusions: Evidence accumulated over the past 25 years supports a shift toward active, individualized, and multidisciplinary approaches to SRC management. Athletic trainers are uniquely positioned to coordinate multifaceted care addressing the diverse contributors to concussion recovery. Full article

In autonomous driving, motion sickness (MS) arises from physical or visual stimuli, or a combination of both. However, objective quantification of MS level (MSL) remains limited beyond questionnaire-based assessments. Using multimodal human signals (physiological and behavioral) collected in an autonomous driving simulator, this study addresses the association between these signals and MSL, across these MS types, by (i) screening and curating a decade of human-signal MS studies (HS-Set) to establish a data-driven foundation for selecting target sensor domains and features, (ii) constructing a dataset with subjective measures of MSL (fast motion sickness scale and simulator sickness questionnaire (SSQ)), alongside human signals (electroencephalogram (EEG), photoplethysmogram (PPG), electrodermal activity (EDA), skin temperature, and head/eye movement), (iii) conducting a correlation analysis between MSL and the identified features from HS-Set, and (iv) quantifying multivariable contributions at the feature and sensor domains through an explainable boosting machine (EBM). Key correlations include head amplitude/energy (pitch/surge) with SSQ total/oculomotor, eye entropy with nausea/oculomotor (positive), and EDA with nausea (negative). The EBM-based contribution analysis highlights EEG connectivity and head kinematics as dominant contributors; excluding EEG, the interpretability of single-domain models remains limited. Additionally, a combination of Head, PPG, and EDA domains retains over 80% of the full model’s interpretability. Full article

Amblyopia is a developmental disorder of spatial vision in which abnormal visual experience leads to persistent reductions in acuity and contrast sensitivity, even after optimal optical correction. We introduce a brief, child-friendly battery of task-evoked eye tracking that probes fixation stability, fine pattern processing, and smooth pursuit control across three simple paradigms. Oculomotor traces are transformed into physiologically interpretable markers—fixation dispersion and saccadic strategy, orientation-dependent drift and stability, pursuit gain, and tracking error—and used to train a compact classifier with subject-wise validation and probability calibration. In a cohort of school-aged participants with clinically diagnosed unilateral amblyopia and age-matched visually normal controls tested under best-corrected viewing conditions, the approach consistently separated groups with stable performance across folds; feature-importance analyses indicated that pursuit- and orientation-dependent markers contributed most. The protocol runs in minutes, is objective and noninvasive, and is well tolerated in pediatric settings. By quantifying functional consequences of amblyopic vision that complement conventional acuity testing, this work positions task-evoked eye movements as practical biomarkers for screening and monitoring, and lays the groundwork for prospective validation and age-stratified norms in community and school-based vision care. Full article

Fluent word reading is a key literacy skill, yet the full extent of the oculomotor underpinnings in developing readers remains unknown. Rapid automatized naming (RAN) is a useful clinical measure that has been shown to predict word reading fluency. Here we use RAN scores to predict early, mid, and late local stages of word reading as measured by eye tracking in children who are at a critical time in their literacy development. Thirty-three children participated in two RAN tasks (rapid letter naming (RLN) and rapid digit naming (RDN)) and an eye-tracking task, which included sentence-level reading with an embedded target word. The eye-tracking measures of first fixation duration, regression path duration, and total word reading time were used as early, mid, and late local measures, respectively. RLN and RDN significantly predicted only the mid-stage of the reading process (regression path duration). Faster RLN and RDN times were associated with briefer regressions from target words. Preliminary results link behavioral RAN performance to a mid-stage oculomotor variable, indicating that children with slower RAN times may exhibit longer regressions during reading, suggesting possible difficulties with the integration of phonological processing skills. Full article

Visual search behavior, influenced by expertise, prior knowledge, training, and visual fatigue, is crucial in ophthalmic diagnostics. This study investigates differences in eye-tracking strategies between novice and experienced eye care practitioners during fundus image interpretation. Forty-seven participants, including 37 novices (first- to fourth-year optometry students) and 10 experienced optometrists (≥2 years of experience), viewed 20 fundus images (10 normal, 10 abnormal) while their eye movements were recorded using an Eyelink1000 Plus gaze tracker (2000 Hz). Diagnostic and laterality accuracy were assessed, and statistical analyses were conducted using Sigma Plot 12.0. Results showed that experienced practitioners had significantly higher diagnostic accuracy (83 ± 6.3%) than novices (70 ± 12.9%, p < 0.005). Significant differences in oculomotor behavior were observed, including median latency (p < 0.001), while no significant differences were found in median peak velocity (p = 0.11) or laterality accuracy (p = 0.97). Diagnostic accuracy correlated with fixation count in novices (r = 0.54, p < 0.001), while laterality accuracy correlated with total dwelling time (r = −0.62, p < 0.005). The experienced practitioners demonstrated systematic and focused visual search patterns, whereas the novices exhibited unorganized scan paths. Enhancing training with visual feedback could improve fundus image analysis accuracy in novice clinicians. Full article

Background: Autism spectrum disorder (ASD) is associated with distinct visual attention patterns that provide insight into underlying social-cognitive mechanisms. Methods: This systematic review (PROSPERO: CRD42023429316), conducted per PRISMA guidelines, synthesizes evidence from 14 peer-reviewed studies using eye-tracking to compare oculomotor strategies in autistic children and typically developing (TD) controls. A comprehensive literature search was conducted in PubMed, Web of Science, and Science Direct up to March 2025. Study inclusion criteria focused on ASD versus TD group comparisons in individuals under 18 years, with key metrics, fixation duration and count, spatial distribution, saccadic parameters systematically extracted. Risk of bias was assessed using the QUADAS-2 tool, revealing high heterogeneity in both index tests and patient selection. Results: The results indicate that autistic children exhibit reduced fixation on socially salient stimuli, atypical saccadic behavior, and more variable spatial exploration compared to controls. Conclusions: These oculomotor differences suggest altered mechanisms of social attention and information processing in ASD. Findings suggest that eye-tracking can contribute valuable information about heterogeneous gaze profiles in ASD, providing preliminary insight that may inform future studies to develop more sensitive diagnostic tools. This review highlights visual attention patterns as promising indicators of neurocognitive functioning in ASD. Full article