⚕️ For Clinical Providers

Objective Oculomotor Assessment
for Every Clinical Setting

ClearGazeTest delivers quantitative neurological biomarkers that subjective exam misses — tracking 12 oculomotor parameters at 500 Hz in 5 minutes, with automated scoring and longitudinal trend analysis ready for integration into your clinical workflow.

Patient Report · Real-Time Output
Saccadic Latency
182 ms
Smooth Pursuit Gain
0.94
Anti-Saccade Inhibition
63%
Pupil Constriction Velocity
2.8 mm/s
Convergence Accuracy
72%
⚠ Oculomotor Pattern — Review Recommended
Assessment Specs
Duration     5 minutes
Sampling    500 Hz binocular
Capture     Infrared VOG
Output      PDF + EHR export
Biomarkers   12 parameters
12
Biomarkers
5 min
Complete assessment
chair-side, no tech required
500 Hz
Binocular infrared
sampling rate
12
Quantitative oculomotor
biomarkers per assessment
EHR
PDF report + structured
data export integration
The Clinical Gap

What Standard Exams Cannot Tell You

Neurological exams rely on subjective observation, patient self-report, and cognitive tools developed before high-speed eye tracking existed. ClearGazeTest closes the quantitative gap across the conditions you see most.

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Concussion & mTBI

SCAT6, ImPACT, and BESS measure symptoms and balance — not the underlying neurological disruption. Oculomotor deficits persist long after symptoms resolve and before they appear, creating both premature return-to-play risk and missed diagnoses in asymptomatic presentations.

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Dementia & MCI Screening

MMSE and MoCA capture mid-to-late stage cognitive decline. Oculomotor biomarkers — saccadic latency, smooth pursuit gain, anti-saccade error rates — are disrupted years earlier, offering a quantitative pre-clinical window that verbal-cognitive tools cannot access.

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Substance Impairment

Urine and blood testing detect past exposure, not current function. Real-time oculomotor assessment detects functional CNS depression from alcohol, cannabis, opioids, benzodiazepines, and stimulants — the clinically relevant question is "is this patient impaired now?"

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Medication Safety Monitoring

CNS-active medications — benzodiazepines, opioids, antihistamines, anticonvulsants — suppress oculomotor function before patients subjectively notice impairment. Baseline-referenced serial assessment enables objective medication titration and fitness-for-duty evaluation.

Vestibular Disorders

BPPV, labyrinthitis, vestibular neuritis, and chronic vestibular dysfunction produce characteristic oculomotor signatures — fixation instability, smooth pursuit breakdown, and convergence error — that enable differentiated diagnosis and objective treatment monitoring.

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Fall Risk Assessment

Balance and gait testing require patient effort and cooperation. Oculomotor biomarkers provide a passive, objective measure of the cerebellar-vestibular integrity that underlies dynamic postural control — particularly valuable in elderly patients and those post-injury.

Technology

Clinical-Grade Video Oculography

ClearGazeTest uses infrared binocular video oculography (VOG) — the same fundamental technology used in academic neuroimaging centers — in a portable, automated clinical tool.

1

Calibration (60 sec)

Patient performs a brief fixation sequence to establish individual baseline. The system accounts for inter-individual variation in eye morphology and prior neurological history. Baseline is stored for longitudinal comparison on subsequent visits.

2

Automated Protocol (4 min)

Structured stimulus battery: pro-saccade, anti-saccade, smooth pursuit, pupillary light reflex, convergence, fixation stability, and scotopic contrast tasks. Protocol is standardized; no operator skill required for administration.

3

Real-Time Analysis

500 Hz infrared binocular capture is processed algorithmically, computing all 12 biomarker values with normative percentile ranks and deviation flags. No manual scoring. Results available before patient leaves the chair.

4

Clinical Report Output

Structured PDF with biomarker values, percentile ranks, normative comparison, trend analysis vs. prior assessments, and a plain-language interpretive summary for documentation. HL7 FHIR export available for EHR integration.

Technical Specifications
Modality Infrared binocular video oculography (VOG)
Sampling Rate 500 Hz (both eyes, simultaneous)
Assessment Duration ~5 minutes, fully automated
Biomarkers 12 quantitative oculomotor parameters
Pupillometry Constriction velocity, re-dilation slope, hippus amplitude
Output PDF report, HL7 FHIR / EHR export, longitudinal dashboard
Normative DB Age- and sex-stratified population norms
Operator Training Clinical MA or RN; no specialist required
Form Factor Portable; desktop or wall-mount configurations
Connectivity Wi-Fi / LAN; HIPAA-compliant cloud or on-premise
Quantitative Output

12 Neurological Biomarkers

Each biomarker reflects activity in distinct neural circuits. Together they create a comprehensive functional signature of current CNS integrity.

01
Saccadic Latency
Time from stimulus onset to saccade initiation. Reflects frontal eye field and superior colliculus integrity. Prolonged in mTBI, MCI, sedation, fatigue.
Pathway: FEF → SC → PPRF
02
Peak Saccadic Velocity
Maximum rotational velocity during saccade. Reduced by cerebellar dysfunction, fatigue, opioids, cannabis. Sensitive marker of brainstem excitability.
Pathway: Cerebellum → Fastigial nucleus → Burst neurons
03
Smooth Pursuit Gain
Ratio of eye velocity to target velocity. Requires continuous cortical-cerebellar coordination. Disrupted by alcohol, cannabis, vestibular lesion, and parieto-occipital injury.
Pathway: MT/MST → Pontine nuclei → Flocculus
04
Corrective Saccade Rate
Frequency of corrective catch-up saccades during pursuit tasks. Elevated in cerebellar ataxia, vestibular dysfunction, and pharmacological CNS depression.
Pathway: Flocculus → Purkinje cells → VN
05
Pupil Constriction Velocity
Peak rate of pupillary constriction to light stimulus. Measures parasympathetic (Edinger-Westphal) function. Depressed by opioids, anticholinergics, and autonomic dysfunction.
Pathway: Pretectal nucleus → Edinger-Westphal → Ciliary ganglion
06
Re-Dilation Slope
Rate of pupil re-expansion after peak constriction. Reflects sympathetic tone. Prolonged by sedatives and fatigue; paradoxically rapid in stimulant intoxication.
Pathway: Locus coeruleus → Sympathetic chain
07
Hippus Oscillation
Low-frequency rhythmic pupil size variation. Normal hippus patterns reflect autonomic balance. Dysrhythmia indicates brainstem or autonomic instability.
Pathway: Autonomic balance — parasympathetic vs. sympathetic
08
Fixation Micro-Instability
Micro-saccades and drift magnitude during fixation tasks. Pathological drift indicates cerebellar or basal ganglia disruption. Elevated in Parkinson's, fatigue, cannabis.
Pathway: Superior colliculus → Omnipause neurons
09
Convergence Accuracy
Precision of binocular convergence on near target. One of the most sensitive post-concussive indicators; also impaired by alcohol and benzodiazepines affecting vergence system.
Pathway: Vergence center → CN III nuclei
10
Anti-Saccade Inhibition
Ability to suppress reflexive saccade toward a distractor. Requires intact prefrontal cortex (DLPFC) and executive inhibitory control. Highly sensitive to alcohol, TBI, and ADHD.
Pathway: DLPFC → FEF → Striatum
11
Contrast Sensitivity
Visual contrast detection threshold. Cannabis reduces contrast sensitivity 30–50% via CB1 receptor activity in retinal ganglion cells and V1. Also reduced in optic neuritis and early glaucoma.
Pathway: Retinal ganglion → LGN → V1 → V4
12
Scotopic Visual Threshold
Minimum detectable luminance under low-light conditions. Rod photoreceptor–mediated; impaired by cannabis, vitamin A deficiency, and retinal pathology. Operationally relevant in low-light settings.
Pathway: Rod photoreceptors → Bipolar → RGC → SC
Clinical Specialties

Built for How You Actually Practice

ClearGazeTest integrates into workflows across neurology, sports medicine, emergency, occupational medicine, geriatrics, and more — each with specialty-specific protocol presets.

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Neurology & Neurorehabilitation

Quantitative serial assessment for TBI, stroke, MS, Parkinson's, MCI, and vestibular disorders. Track treatment response and rehabilitation progress with objective oculomotor endpoints.

TBI / Concussion Dementia Screening MS Monitoring Vestibular Dx
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Sports Medicine & Concussion Clinics

Objective pre-season baseline, real-time sideline assessment capability, and safe return-to-play decision support grounded in quantitative neurological data — not symptom self-report alone.

Pre-Season Baseline Post-Injury Eval RTP Clearance Serial Monitoring
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Emergency Medicine

Rapid chair-side assessment for altered mental status, suspected intoxication, or head trauma. Quantitative oculomotor signature distinguishes impairment mechanisms — critical for triage and disposition decisions.

AMS Evaluation Intoxication Screen Head Trauma Triage Rapid Screening
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Occupational Medicine

Pre-employment baseline, fitness-for-duty evaluation, post-incident assessment, and return-to-work clearance for safety-sensitive positions in aviation, transportation, and heavy industry.

Fitness-for-Duty Post-Incident Pre-Employment Return-to-Work
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Geriatrics & Primary Care

Annual cognitive monitoring, fall risk assessment, medication safety screening, and early detection of neurodegenerative change. Passive, non-demanding assessment ideal for older patients.

Annual Baseline Fall Risk Medication Safety Cognitive Monitoring
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Addiction Medicine & Pain Management

Objective pharmacodynamic monitoring for patients on opioids, benzodiazepines, or in recovery. ClearGazeTest provides quantitative CNS depression measurement beyond patient self-report and pill counts.

Opioid Monitoring Benzo Safety Sobriety Monitoring Pain Med Titration
Clinical Comparison

How ClearGazeTest Compares

Standard neurological and cognitive tools were developed for different clinical questions. See where quantitative oculomotor assessment fills the gap.

Capability SCAT6 / BESS ImPACT / MoCA Standard Eye Exam ClearGazeTest
Quantitative biomarkers (not symptom-based) Partial
Detects impairment before symptoms appear
Real-time substance impairment detection
Longitudinal trend / serial monitoring Limited
Medication effect quantification
Administration time 20–30 min 15–25 min 20–40 min 5 min
Non-specialist administration
Effort-independent (passive measure) Partial
Scientific Foundation

Grounded in Peer-Reviewed Oculomotor Science

ClearGazeTest biomarkers are derived from decades of published oculomotor neuroscience across neurology, ophthalmology, vestibular medicine, and pharmacology.

Concussion & TBI Literature

  • Oculomotor deficits (smooth pursuit, saccadic latency) persist 3–6 weeks post-concussion even after symptom resolution — King et al., Neurology
  • Convergence insufficiency is the most common post-concussive finding in athlete populations — Mucha et al., BJSM
  • Anti-saccade error rates discriminate concussed athletes from controls with >90% sensitivity — Galetta et al., Annals of Neurology
  • Second-impact syndrome risk is elevated when oculomotor metrics remain abnormal even in symptom-free athletes
  • Oculomotor screening reduces safe return-to-play time errors vs. symptom-based assessment alone

Neurodegeneration & Aging

  • Saccadic latency increases 2–4 years before MMSE scores detect MCI — Kapoula et al., Frontiers in Aging Neuroscience
  • Smooth pursuit gain reduction precedes clinical dementia diagnosis in longitudinal cohort studies
  • Fixation micro-instability correlates with Parkinson's motor score (UPDRS) independent of medication status
  • Convergence deficits in adults 65+ are predictive of fall events in 12-month prospective studies
  • Anti-saccade error rates correlate with hippocampal volume on MRI in MCI subjects

Substance Impairment Science

  • Cannabis reduces contrast sensitivity 30–50% at recreational doses via CB1 receptor activity — Dawkins et al., Psychopharmacology
  • Smooth pursuit gain correlates linearly with blood alcohol concentration (r = −0.84) — Wetherill et al.
  • Pupil constriction velocity is suppressed dose-dependently by opioids — Behrends et al., Anesthesiology
  • Anti-saccade performance is acutely impaired by benzodiazepines even at therapeutic doses
  • Oculomotor impairment from THC persists 3–4 hours after subjective "soberness" is reported

Vestibular & Autonomic

  • Video head impulse test (vHIT) abnormalities mirror oculomotor VOG patterns in superior canal dehiscence
  • Hippus oscillation dysrhythmia correlates with autonomic neuropathy severity in diabetic cohorts
  • Pupillary re-dilation slope is a validated measure of sympathovagal balance — task-force recommendations
  • Fixation stability under suppressed VOR predicts vestibular compensation outcomes in labyrinthitis
  • Oculomotor profiles distinguish central from peripheral vestibular lesions with >85% specificity
Clinical Integration

Fits Into Your Existing Workflow

ClearGazeTest is designed for practical clinical environments — not research labs. Minimal staff training, no specialist operator, and structured output that documents itself.

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EHR Integration

HL7 FHIR structured export, PDF addendum, or direct EHR workflow integration for major platforms.

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Longitudinal Dashboard

Patient-level trend analysis across visits. Visual biomarker trajectories that support clinical narrative documentation.

👩‍⚕️

MA / RN Administration

No specialist required. Clinical MA or RN can administer the full protocol after standard training. Physician reviews report.

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Auto-Generated Report

Structured clinical report with biomarker values, normative comparison, trend analysis, and interpretive summary. Chart-ready.

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HIPAA Compliant

Cloud or on-premise deployment options. All data encrypted at rest and in transit. SOC 2 Type II audit path.

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Patient Portal Output

Configurable patient-facing summary for portal delivery — supports engagement and shared decision-making in follow-up discussions.

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CPT Alignment

Assessment aligns with existing CPT codes for neurobehavioral testing, vestibular function, and neuropsychological evaluation. Discuss coding with your billing team.

⚙️

Protocol Presets

Specialty-specific protocol configurations — concussion, geriatric, occupational, addiction — each optimized for clinical question and time available.

"Oculomotor assessment is the EKG of the brain — it gives you objective, real-time electrical signatures of neurological function that cannot be faked, coached, or influenced by the patient's effort or subjective report."
— Neurological assessment principle underlying clinical VOG methodology
Clinical FAQ

Questions from Clinicians

The ClearGazeTest report is designed for physician interpretation without prior oculomotor expertise. Each biomarker includes a normative percentile rank, population-referenced deviation flag, and an interpretive plain-language summary. Pattern-based interpretive guidance is included in the clinical reference guide provided at onboarding. For practices wishing to develop deeper expertise, we offer a half-day CME-eligible virtual clinical training module covering oculomotor neuroanatomy, biomarker interpretation, and specialty application.

ClearGazeTest is a quantitative screening and monitoring tool, not a replacement for comprehensive neuro-ophthalmology evaluation when that is clinically indicated. Its strengths are speed (5 minutes), objectivity (quantitative rather than observer-dependent), repeatability (longitudinal trend analysis), and breadth (12 parameters across multiple neural systems). For complex neuro-ophthalmic presentations, ClearGazeTest provides useful objective data that complements, not replaces, specialist evaluation.

ClearGazeTest assessment requires the ability to focus on visual stimuli and follow basic instructions. Patients with severe visual acuity loss, significant strabismus not corrected by glasses, inability to follow simple directions, or acute agitation may yield incomplete or non-interpretable results. The system flags incomplete data segments. Patients with known amblyopia, monocular vision, or significant refractive error should be noted in the record — the system accommodates monocular assessment when binocular data is not feasible. There are no radiation, contact, or pharmacological components; the assessment is non-invasive.

ClearGazeTest produces quantitative, timestamped, instrumentally-derived data — which is a different evidentiary class than observer-dependent clinical findings. In occupational, fitness-for-duty, and regulatory contexts, objective measurement is generally more defensible than subjective assessment. We provide detailed methodology documentation and can provide expert witness support through our clinical advisory network when required. Specific legal admissibility depends on jurisdiction and proceeding type; consult legal counsel for case-specific guidance.

Implementation follows a structured onboarding pathway: hardware installation (half-day), system configuration and EHR integration setup, staff administration training (2–4 hours), and physician clinical interpretation briefing (1–2 hours). Most practices are fully operational within two weeks of delivery. Ongoing support includes dedicated clinical success management, monthly software updates, normative database updates as population data expands, and access to our clinical advisory team for complex interpretation questions. Contact us for a site-specific implementation timeline.

All 12 biomarkers are referenced against an age- and sex-stratified normative population database. Individual result percentile ranks reflect where the patient's values fall within their demographic cohort. The system also builds individual patient baselines over multiple visits, enabling deviation-from-personal-baseline reporting — which is particularly valuable for serial monitoring in concussion management, medication adjustment, and neurodegenerative disease progression tracking. Normative data is continuously updated as the clinical database expands.

Get Started

Request a Clinical Demo

Speak with a ClearGazeTest clinical specialist. We'll walk through the assessment workflow, review sample reports from your specialty, and discuss implementation for your practice.

⚕️

Clinical Partnerships

ClearGazeTest · Medical Card Exam
clinical@medicalcardexam.com

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Academic & Research Inquiries

We support IRB-approved research protocols and can provide technical documentation, normative data access, and co-investigation partnerships.

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Multi-Site & Health System Deployment

Custom implementation pathways for hospital systems, multi-specialty groups, and integrated health networks. Contact our enterprise clinical team.

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CME & Clinical Education

CME-eligible oculomotor neuroscience training available for clinical teams. Contact us for group training scheduling and CE credit documentation.