Eye Movement Analysis May Serve as Biomarker for Glaucoma Diagnosis

The strong correlation between saccadic parameters and conventional glaucoma metrics suggests that eye movement analysis provides a window into the functional consequences of glaucomatous damage. Study suggests that eye-tracking technology could be a complementary diagnostic tool for early glaucoma detection. These charts from the study show a comparison of two saccadic parameters evaluated by the researchers. Photo: Elgin Yuksel C. J Eye Mov Res. 2025;18(3):18. Click image to enlarge. Detecting glaucoma early is crucial to help prevent vision loss, but most diagnostic methods identify the disease after significant damage has occurred. In a recent study, researchers developed and validated a novel eye-tracking algorithm that detected oculomotor abnormalities in primary open-angle glaucoma (POAG) in their saccadic eye movements, particularly when executing saccades toward moving targets. These oculomotor deficits could be detected even in patients with preperimetric glaucoma and correlated with conventional metrics of disease severity, showing that eye movement analysis may serve as a sensitive biomarker for early glaucoma damage. The findings were reported in Journal of Eye Movement Research.This case-control study included 16 patients with moderate POAG, 16 with preperimetric POAG and 16 age-matched controls. The participants underwent a comprehensive ophthalmic examination and eye movement recording using a high-resolution infrared tracker during two tasks: saccades to static targets and saccades to moving targets.The patients with POAG exhibited a significantly increased saccadic latency and reduced accuracy compared to the controls, with more pronounced differences in the moving target task. Notably, preperimetric POAG patients showed significant abnormalities despite having normal visual fields based on standard perimetry. The researchers used area under the curve (AUC) analysis to test the strength of the association.“Our machine learning algorithm incorporating multiple saccadic parameters achieved an excellent discriminative ability between glaucomatous and healthy subjects (AUC = 0.92), with particularly strong performance for moderate POAG (AUC = 0.97) and good performance for preperimetric POAG (AUC = 0.87),” the authors wrote in their Journal of Eye Movement Research paper.POAG patients showed significant abnormalities in their saccadic eye movements, particularly when tracking moving targets. The eye-tracking algorithm successfully distinguished between glaucomatous and healthy controls with high sensitivity and specificity (88.5% and 86.7%, respectively).The increase in the saccadic latency among glaucoma patients aligns with previous study findings. “Delayed saccades have been reported in POAG patients, with more pronounced delays when tracking moving targets compared to static ones,” the authors explained in their article. “Our results extend these observations by demonstrating a gradient of impairment that correlates with the disease severity, with preperimetric patients showing intermediate values between those of controls and those of patients with moderate glaucoma.”Previous research has shown that glaucoma patients have difficulties in localizing peripheral targets, which could have contributed to the hypometric saccades observed in this study.What the authors found interesting is that the parameters derived from the moving target task contributed most significantly to the algorithm’s diagnostic performance. This “aligns with the growing recognition that dynamic visual tasks may be more sensitive than static ones for detecting functional vision loss in glaucoma,” according to the paper.Previous studies found that motion discrimination thresholds were elevated in glaucoma patients, and motion-defined form tasks were significantly impaired, which correlated with self-reported difficulties in daily activities. “Our results extend these observations to the domain of oculomotor control, suggesting that eye movement responses to moving stimuli may provide a sensitive window into early visual dysfunction in glaucoma,” the authors explained in their article.Also, the researchers found the high diagnostic performance of their algorithm, particularly for preperimetric glaucoma, promising. “Importantly, these oculomotor deficits were detectable even in preperimetric glaucoma patients who had not yet developed visual field defects according to standard automated perimetry,” the authors noted in their paper. “The strong correlation between saccadic parameters and conventional glaucoma metrics suggests that eye movement analysis provides a window into the functional consequences of glaucomatous damage.”In conclusion, the researchers propose that eye tracking could complement current diagnostic methods by serving as a rapid, noninvasive and objective screening tool that could enable earlier intervention and improve visual outcomes.Click here for the journal source. Elgin Yuksel C. Eye-tracking algorithm for early glaucoma detection: analysis of saccadic eye movements in primary open-angle glaucoma. J Eye Mov Res. 2025;18(3):18.