Michael D. Duplessie, FRCS Ophth (Glasgow).
I have spent more than three decades looking at how the eye works, what it can tell us about the brain, and what happens when we measure both with the precision the science has always promised but the bedside has never quite delivered.
I trained in clinical neuro-ophthalmology and ophthalmic pathology at the National Eye Institute of the National Institutes of Health, as a fellow of Dr. David G. Cogan - the physician who founded neuro-ophthalmology as a clinical subspecialty and who spent his final career years at NIH mapping the connection between how the eyes move and what the brain is doing. The principle Dr. Cogan taught me - that the eye is the most accessible output of the central nervous system, and that careful measurement of how it moves is one of the most informative windows we have onto neurological function - is the design specification of everything I have built since. It is the design specification of ClearGazeTest.
After the National Eye Institute, I trained in ophthalmic pathology under Dr. Gordon Klintworth at Duke University and in cornea, external disease, and refractive surgery under Dr. J. James Rowsey at the University of South Florida. At the University of South Florida I organized the first United States course on laser-assisted in situ keratomileusis - LASIK, the procedure that has now corrected vision for tens of millions of people worldwide - and edited the foundational textbook of the field, Advances in Refractive and Corneal Surgery (International Ophthalmology Clinics 36(4), 1996). I wrote the first textbook chapters describing the surgical techniques for nearsighted and farsighted LASIK and helped establish the terminology the field uses today.
The thirty-two years that followed have been spent inside laser-based eye-tracking systems at the clinical surgical interface. I performed more than one hundred LASIK procedures in a single day at the height of clinical practice. I helped pioneer lamellar corneal transplantation and the excimer and femtosecond laser correction of presbyopia. From 2000 to 2013, I served as Chief Executive Officer of the Cataract and Laser Eye Institute in Bethesda, Maryland - an integrated ambulatory surgery center, excimer laser center, corneal fellowship training program, and eye-charity program - which closes a circle I want to come back to in a moment.
From 2013 to 2018 I served as Chairman of Ophthalmology and Head of Cornea and Refractive Surgery at Kuwait Hospitals. In 2020 I founded Medical Card Exam, a physician-led multi-state telemedicine platform that has now delivered regulated care to more than thirty thousand patients, and ANCHOR, a national real-world-data initiative tracking outcomes, dosing, and patient experience across a population the conventional clinical-trial system was not built to serve.
ClearGazeTest is the convergence of all of it. The Cogan principle that the eye reveals the brain. The thirty-five years inside laser-based eye-tracking. The clinical-scale operations infrastructure. The instinct, after a career spent looking at corneas, to follow the measurement arc into the central nervous system - where the more important questions live.
The platform measures fifteen distinct neuro-ocular biomarkers - saccadic latency, peak velocity, accuracy, vertical saccades, antisaccade performance, reading saccades, smooth pursuit, vergence, the vestibulo-ocular reflex, fixation stability via the bivariate contour ellipse area, contrast sensitivity, optokinetic nystagmus, inter-saccadic interval, the pupillary light reflex with the relative afferent pupillary defect, and reaction time - with an additional research-direction layer that probes the limbic, amygdala, and autonomic responses lying underneath conscious awareness. Every stimulus parameter is anchored to peer-reviewed primary literature indexed in the National Library of Medicine's PubMed database. The platform runs on the Varjo XR-4 Secure Edition head-mounted display, already in active operational service across the United States Army, the United States Air Force, and the broader North Atlantic Treaty Organization (NATO) alliance, and on the consumer-scale Samsung Galaxy XR.
It is the work I have been building toward, in one form or another, for thirty-five years. It is the work I will be doing for the rest of my career.