Awareness and Perceived Value of Eye Tracking Technology for Concussion Assessment among Sports Medicine Clinicians: A Multinational Study.

Objective: The awareness of concussion as a serious and frequently occurring sports injury and its management has evolved significantly. One viable objective diagnostic tool is eye tracking technology. The authors hypothesized that while clinicians may be aware that assessing eye movements in concussed athletes can be beneficial, it is possible that, due to the novelty of the eye tracking technology and limited exposure, only a few actually use it in their practice. The study aimed to assess the awareness of eye movement deficits associated with concussion amongst sports medicine clinicians and to determine the utilization and perceptions of the eye tracking technology for concussion diagnosis.Methods: An online 18-question survey was distributed internationally from January until December 2017 and completed by 171 sports medicine clinicians (sport physicians, therapists, general practitioners, neuropsychologists) from 32 countries.Results: Respondents indicated that subjectivity of assessments remained a major limitation of established diagnostic tools. Eye tracking technology, despite its potential to attenuate this limitation, was only used by 12% of respondents. To diagnose concussion, 77% did not use any eye movement assessment tools other than own clinical assessment. With the exception of abnormal pupil light reflex, which was checked by 68%, eye movement deficits were inspected by less than half of the respondents (46.3 ± 12%).Conclusion: Even among sports medicine clinicians who regularly attend to patients with concussions, there is insufficient awareness that concussion can lead to abnormal eye tracking behavior. Lack of exposure to the sensitive eye tracking equipment may be a limiting factor for using eye movement metrics for concussion diagnostics. Facilitating the awareness of objective methods, like eye tracking technology, may help assure the appropriate continuum of identification and treatment for concussed athletes. Increasing educational opportunities and practical experience of clinicians regarding concussive symptoms and potential innovative technology is strongly advocated.