Self-Recording of Eye Movements in Amyotrophic Lateral Sclerosis Patients Using a Smartphone Eye-Tracking App

Pouya Barahim Bastani; Ali S Saber Tehrani; Shervin Badihian; Hector Rieiro; David Rastall; Nathan Farrell; Max Parker; Jorge Otero-Millan; Ahmed Hassoon; David Newman-Toker; Lora L Clawson; Alpa Uchil; Kristen Riley; Steven R Zeiler

doi:10.1159/000538992

Self-Recording of Eye Movements in Amyotrophic Lateral Sclerosis Patients Using a Smartphone Eye-Tracking App

Digit Biomark. 2024 Jun 18;8(1):111-119. doi: 10.1159/000538992. eCollection 2024 Jan-Dec.

Authors

Pouya Barahim Bastani^{1

2}, Ali S Saber Tehrani¹, Shervin Badihian^{2

3}, Hector Rieiro^{1

2}, David Rastall¹, Nathan Farrell^{1

2

4}, Max Parker⁵, Jorge Otero-Millan^{1

6}, Ahmed Hassoon⁴, David Newman-Toker^{1

2

4}, Lora L Clawson¹, Alpa Uchil¹, Kristen Riley¹, Steven R Zeiler¹

Affiliations

¹ Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
² Armstrong Institute Center for Diagnostic Excellence, Baltimore, MD, USA.
³ Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
⁴ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁵ Department of Neurology, NYU Langone Health, New York, NY, USA.
⁶ Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, CA, USA.

Abstract

Introduction: Amyotrophic lateral sclerosis (ALS) can affect various eye movements, making eye tracking a potential means for disease monitoring. In this study, we evaluated the feasibility of ALS patients self-recording their eye movements using the "EyePhone," a smartphone eye-tracking application.

Methods: We prospectively enrolled ten participants and provided them with an iPhone equipped with the EyePhone app and a PowerPoint presentation with step-by-step recording instructions. The goal was for the participants to record their eye movements (saccades and smooth pursuit) without the help of the study team. Afterward, a trained physician administered the same tests using video-oculography (VOG) goggles and asked the participants to complete a questionnaire regarding their self-recording experience.

Results: All participants successfully completed the self-recording process without assistance from the study team. Questionnaire data indicated that participants viewed self-recording with EyePhone favorably, considering it easy and comfortable. Moreover, 70% indicated that they prefer self-recording to being recorded by VOG goggles.

Conclusion: With proper instruction, ALS patients can effectively use the EyePhone to record their eye movements, potentially even in a home environment. These results demonstrate the potential for smartphone eye-tracking technology as a viable and self-administered tool for monitoring disease progression in ALS, reducing the need for frequent clinic visits.

Keywords: Amyotrophic lateral sclerosis; Eye movements; Health technology; Smartphone eye-tracking application.

Grants and funding

This study received no funding.