Researchers at Children’s Hospital of Philadelphia (CHOP) have found that new eye-tracking metrics can help identify vision disorders related to concussions in children and adolescents with symptoms lasting more than 28 days. Their study, published in the Journal of Sport and Health Science, points to the use of infrared eye tracking as a tool for clinicians to determine which patients may benefit from referral to concussion specialists.
In the United States, almost two million pediatric concussions occur each year. While most children recover within four weeks, up to 30% continue to experience symptoms that can affect school performance and physical activity. Early detection of concussion-related vision disorders is important for improving patient outcomes.
The research team enrolled 108 adolescents with persistent post-concussive symptoms. Each participant underwent a visio–vestibular examination (VVE), a comprehensive vision exam, and an assessment using an eye-tracking device. Of those studied, 62% were diagnosed with a concussion-related vision disorder through the comprehensive exam. The most common diagnosis was convergence insufficiency, which leads to double vision and visual fatigue during close-up tasks like reading.
The study used EyeBOX technology to record gaze positions while subjects watched a video. Higher BOX scores were associated with a greater likelihood of having a concussion-related vision disorder. Patients with such disorders had average BOX scores significantly higher than those without (8.1 ± 5.8 vs. 5.2 ± 4.1; p = 0.007). According to the findings, each one-point increase in BOX score raised the odds of experiencing a concussion-related vision disorder by 15%.
“A comprehensive vision examination by an eyecare professional remains the basis for making the diagnosis for a concussion-related vision disorders, which might be missed during a typical concussion evaluation,” said Christina L. Master, MD, senior study author and co-director of CHOP’s Minds Matter Concussion Program. “The earlier we can identify these vision disorders through easy-to-use objective means, the earlier we can refer patients to specialists to get a proper diagnosis and start receiving more specialized treatment.”
“Our study strongly suggests that eye-tracking technology could significantly augment current clinical concussion evaluations, ensuring that patients with ongoing vision symptoms are identified promptly and are referred for rehabilitation for their concussion-related vision disorder,” Master added.
This work received support from the National Institute of Neurological Disorders and Stroke under grant number 1R41NS103698-01A1.
Master et al., “Metrics of concussion-related vision disorders among children and adolescents with persisting post-concussive symptoms using an objective eye tracking device.” J Health Sport Sci., July 15, 2025.
