A survey and review of eye-tracking in clinical practice

Purpose. The aim of this study was to evaluate how eye-trackers are currently used in clinical settings and to explore whether guidelines are perceived to be needed to support their use in a clinical context. Methods. A survey was developed and distributed to clinical eye-tracker users, manufacturers, professional bodies and other key stakeholders. The survey explored current practices, perceived barriers to clinical eye-tracking, guideline availability, and the perceived need for guidelines to support clinical practice. Results. Eighty responses to at least one of the survey questions were received. Of these, three were excluded from some analyses due to having no clinical involvement in eye-tracking (their involvement was in research only). Eye-tracking was performed by ophthalmologists, orthoptists, neurologists, optometrists, allied scientists and audiologists. Whilst most respondents were assessing eye movements daily, eye-tracking was mostly performed either rarely (less than 10%) or moderately often (10-60%) in their practice. Most clinical respondents (76%) reported they both performed eye-tracking and interpreted the results. The most commonly identified barriers to clinical eye-tracking were eye-trackers being considered primarily research tools, considered unsuitable for performing the assessments, and lack of access to an eye-tracker. Most respondents (71%) were unaware of any existing guidelines for clinical eye-tracking. Where guidelines were reported to exist, they were described as somewhat sufficient to completely insufficient. Most respondents (93%) supported the development of guidelines for clinical eye-tracking. A small number of respondents (7%) reported concerns about introducing clinical eye-tracking guidelines. Conclusion. A broad range of clinicians, professionals and other stakeholders involved in clinical eye-tracking responded to this survey. Their responses suggest a general consensus of a need for clinical eye-tracking guidelines. Whilst guidelines may address some of the reported barriers to eye-tracking clinically, and support benchmarking and standardisation across a broad range of clinical disciplines, concerns around a perceived threat to autonomous clinical practice should also be considered.