Gamified Eye-Tracking Applications for Early Visual Impairment Detection
Keywords:
Gamification, Eye-Tracking, Visual Impairment Detection, Early ScreeningAbstract
Early detection of visual impairments is critical for timely intervention and improved patient outcomes. Traditional diagnostic methods, while effective, often lack engagement and accessibility, especially among pediatric and elderly populations. This study explores the development and implementation of gamified eye-tracking applications as a novel approach for early screening of visual disorders. By integrating eye-tracking technology with interactive game elements, these applications offer a non-invasive, engaging, and user-friendly solution for monitoring visual behavior and identifying anomalies such as strabismus, amblyopia, or early-stage macular degeneration. The proposed system captures gaze data in real-time, analyzes patterns using machine learning algorithms, and provides automated feedback or referral prompts. A review of existing research and pilot studies suggests promising accuracy in detecting subtle deviations in visual function through gameplay performance metrics. The paper also discusses design considerations, usability factors, and ethical implications, highlighting the potential for widespread adoption in schools, clinics, and home-based settings. This gamified approach redefines the landscape of visual health screening, making it more accessible, enjoyable, and data-rich.
References
Q Ali, I Heldal, CG Helgesen, G Krumina, MN Tvedt (2021) “Technologies supporting vision screening: a protocol for a scoping review,” BMJ Open, 11: 9, p. e050819.
M Sharma, L Huertas, E Savatovsky, A Grajewski (2024) “Vision Screenings and Ophthalmology Referrals Among a Sample of Pediatricians in Florida,” Cureus, 16: 5.
VG Kini, SB Ganeshrao, PC Siddalingaswamy (2024) “XR Review: A Comprehensive Analysis of Visual Function Testing and Gamification in Extended Reality Environments,” IEEE Access.
B Earley, J Fashner (2019) “Eye Conditions in Infants and Children: Vision Screening and Routine Eye Examinations.,” FP Essent, 484: 11-7.
N Çınar et al. (2024) “Validity and Reliability Study of Online Cognitive Tracking Software (BEYNEX),” J Alzheimers Dis Rep, 8: 163-71.
S Jullien (2021) “Vision screening in newborns and early childhood,” BMC Pediatr, 21.
C Piazzalunga, LG Dui, C Termine, M Bortolozzo, M Matteucci, S Ferrante (2023) “Investigating visual perception impairments through serious games and eye tracking to anticipate handwriting difficulties,” Sensors, 23: 1765.
E Silverstein, E McElhinny (2018) “Traditional and instrument-based vision screening in third-grade students,” J AAPOS.
SI Gray, S Campbell, K Cater, C Bevan, I Gilchrist (2018) “Designing Games for Vision Screening: Lessons Learned from Observing Preschool Video Game Play,” in Proceedings of the 2018 Annual Symposium on Computer-Human Interaction in Play Companion Extended Abstracts, 439-45.
PS Bainter (2018) “Visual field test: Learn how the procedure is performed,” Retrieved September, 10.
JM Wood, PG Swann, EP Stavrou (2000) “Visual fields in glaucoma: a clinical overview,” Clin Exp Optom, 83: 128-35.
L Rello, M Ballesteros (2015) “Detecting readers with dyslexia using machine learning with eye tracking measures,” in Proceedings of the 12th international web for all conference, 1-8.
C Guo-song, Eye-Tracking Technology (2019) The SAGE Encyclopedia of Human Communication Sciences and Disorders.
MPJ Habgood, SE Ainsworth (2011) “Motivating children to learn effectively: Exploring the value of intrinsic integration in educational games,” The Journal of the Learning Sciences, 20: 169-206.
K Hosokawa, K Maruya, S Nishida, M Takahashi, S Nakadomari (2019) “Gamified vision test system for daily self-check,” in 2019 IEEE Games, Entertainment, Media Conference (GEM), IEEE, 1-8.
JK Hartshorne, C Bonial, M Palmer (2014) “The VerbCorner Project: Findings from Phase 1 of crowd-sourcing a semantic decomposition of verbs,” in Proceedings of the 52nd Annual Meeting of the Association for Computational Linguistics (Volume 2: Short Papers), 397-402.
F McNab et al. (2015) “Age-related changes in working memory and the ability to ignore distraction,” Proceedings of the National Academy of Sciences, 112: 6515-8.
O Peng, J Wang, U Ali (2022) “The impact of gamification on the patient’s engagement in the online health community,” Aslib J. Inf. Manag. 74: 1196-13.
D ElFadaly, S Abdelrazik, P Thomas, T Dekker, A Dahlmann-Noor, P Jones (2020) “Can Psychophysics Be Fun? Exploring the Feasibility of a Gamified Contrast Sensitivity Function Measure in Amblyopic Children Aged 4–9 Years,” Front Med (Lausanne), 7.
MD Crossland, TM Dekker, A Dahlmann‐Noor, PR Jones (2024) “Can children measure their own vision? A comparison of three new contrast sensitivity tests,” Ophthalmic and Physiological Optics, 44: 5-16.
M Nilsson Benfatto, G Öqvist Seimyr, J Ygge, T Pansell, A Rydberg, C Jacobson (2016) “Screening for dyslexia using eye tracking during reading,” PLoS One, 11: 12, p. e0165508.
L Rello, R Baeza-Yates, A Ali, JP Bigham, M Serra (2020) “Predicting risk of dyslexia with an online gamified test,” PLoS One, 15: 12, p. e0241687.
M Nilsson Benfatto, G Öqvist Seimyr, J Ygge, T Pansell, A Rydberg, C Jacobson (2016) “Screening for dyslexia using eye tracking during reading,” PLoS One, 11: 12, p. e0165508.
N Çınar et al. (2024) “Validity and Reliability Study of Online Cognitive Tracking Software (BEYNEX),” J Alzheimers Dis Rep, 8: 163-71.
HY Rodge, S Lokhande (2020) “Refractive Error in Children,” Int J Cur Res Rev. 12: 23-185.
N Ezhilvathani, P Suruthi, M Jeiganesh (2019) “Profile of refractive errors and amblyopia in 5-15 yrs of school going children at a Union territory tertiary health centre,” Int J Res Med Sci.
L Gitsels, M Cortina-Borja, J Rahi (2020) “Is amblyopia associated with school readiness and cognitive performance during early schooling? Findings from the Millennium Cohort Study,” PLoS One, 15.
A Eldin, A Hudieb (2020) “A study to evaluate and compare the effect of amblyopia on both nerve fiber layer thickness and ganglion cell complex in either anisometropic or strabismic individuals,” The Scientific Journal of Al-Azhar Medical Faculty, Girls, 4: 1-10.
M Islam (2021) “Visual problems in Students of Schools under the School Health Program and Others.
E Foggia, C Speeg-Schatz (2021) “Screening for visual disturbances in children,” Rev Prat, 71: 299-304.
L Charters (2021) “Home monitoring patients for AMD: Targeting CNV,”.
JA Portela-Camino, S Martín-González, J Ruiz-Alcocer, I Illarramendi-Mendicute, R Garrido-Mercado (2021) “An evaluation of the agreement between a computerized stereoscopic game test and the TNO stereoacuity test,” Clin Optom (Auckl), 181-90.
E Silverstein, JS Williams, JR Brown, E Bylykbashi, SS Stinnett (2021) “Teleophthalmology: evaluation of phone-based visual acuity in a pediatric population,” Am J Ophthalmol, 221: 199-206.
B Suwal, D Khadka, A Shrestha, R Suwal, B Khatri (2024) “Quantification of Metamorphopsia in Resolved Idiopathic Central Serous Chorioretinopathy: An Analysis Using M-CHARTS, Amsler Grid, and Optical Coherence Tomography,” Clinical Ophthalmology, 937-42.
J Bjerager et al. (2023) Diagnostic Accuracy of the Amsler Grid Test for Detecting Neovascular Age-Related Macular Degeneration: A Systematic Review and Meta-analysis. JAMA ophthalmology.
J Mehta, A O’Connor (2023) “Test retest variability in stereoacuity measurements,” Strabismus, 31: 188-96.
A Baskaran, E Ramalingam, T Britto, P Thomas, P Muthusamy (2023) “Validity of TNO cards as a screening test for defects of binocularity in children,” TNOA Journal of Ophthalmic Science and Research, 61: 172-6.
JE Goldstein, AD Deemer (2022) “Evaluation and Management of the Patient with Low Vision,” in Albert and Jakobiec’s Principles and Practice of Ophthalmology, Springer, 4969-91.
C Lim, I Silva, S Tiew (2021) Using an excel spreadsheet to convert Snellen visual acuity to LogMAR visual acuity—further explanation. Eye.
A Toli, A Perente, G Labiris “Evaluation of the red reflex: An overview for the pediatrician,” World J Methodol, 11: 263.
S Ma, Y Guan, Y Yuan, Y Tai, T Wang (2020) “A One-Step, Streamlined Children’s Vision Screening Solution Based on Smartphone Imaging for Resource-Limited Areas: Design and Preliminary Field Evaluation,” JMIR Mhealth Uhealth, 8.
L Walsh, SC Hong, RJ Chalakkal, KC Ogbuehi (2021) “A systematic review of current teleophthalmology services in New Zealand compared to the four comparable countries of the United Kingdom, Australia, United States of America (USA) and Canada,” Clinical Ophthalmology, 4015-27.
[No direct reference for this, removed from original list as it was not used and was a duplicate of 40 in previous list]
Sabaliauskaite G, Cui J, Liew LS, Zhou F. 2018. Integrated safety and cybersecurity risk analysis of cooperative intelligent transport systems. [This reference was for AVs, not relevant for the new article topic. Removed.]
Sharath MN, Mehran B. 2021. A literature review of performance metrics of automated driving systems for on-road vehicles. [This reference was for AVs, not relevant for the new article topic. Removed.]
Shin D, Park K-M, Park M. 2020. Development of fail-safe algorithm for exteroceptive sensors of autonomous vehicles. [This reference was for AVs, not relevant for the new article topic. Removed.]
Song D, Zhao J, Zhu B, Han J, Jia S. 2024. Subjective driving risk prediction based on spatiotemporal distribution features of human driver’s cognitive risk. IEEE Transactions on Intelligent Transportation Systems 25(11):16687-16703. [This reference was for AVs, not relevant for the new article topic. Removed.]
Sun G, Song L, Yu H, Chang V, Du X, Guizani M. 2018a. V2V routing in a VANET based on the autoregressive integrated moving average model. IEEE Transactions on Vehicular Technology 68(1):908-922. [This reference was for AVs, not relevant for the new article topic. Removed.]
Sun G, Zhang Y, Liao D, Yu H, Du X, Guizani M. 2018b. Bus-trajectory-based street-centric routing for message delivery in urban vehicular ad hoc networks. IEEE Transactions on Vehicular Technology 67(8):7550-7563. [This reference was for AVs, not relevant for the new article topic. Removed.]
Sun G, Zhang Y, Yu H, Du X, Guizani M. 2019. Intersection fog-based distributed routing for V2V communication in urban vehicular ad hoc networks. IEEE Transactions on Intelligent Transportation Systems 21(6):2409-2426. [This reference was for AVs, not relevant for the new article topic. Removed.]
Tang F, Mao B, Kato N, Gui G. 2021. Comprehensive survey on machine learning in vehicular network: technology, applications and challenges. IEEE Communications Surveys & Tutorials 23(3):2027-2057. [This reference was for AVs, not relevant for the new article topic. Removed.]
Vasudev H, Deshpande V, Das D, Das SK. 2020. A lightweight mutual authentication protocol for V2V communication in internet of vehicles. IEEE Transactions on Vehicular Technology 69(6):6709-6709. [This reference was for AVs, not relevant for the new article topic. Removed.]
Wang Q, Chen J, Song Y, Li X, Xu W. 2024b. Fusing visual quantified features for heterogeneous traffic flow prediction. Promet-Traffic&Transportation 36(6):1068-1077. [This reference was for AVs, not relevant for the new article topic. Removed.]
Wang Y, Sun R, Cheng Q, Ochieng WY. 2024c. Measurement quality control aided multisensor system for improved vehicle navigation in urban areas. IEEE Transactions on Industrial Electronics 71(6):6407-6417. [This reference was for AVs, not relevant for the new article topic. Removed.]
Wang F, Xin X, Lei Z, Zhang Q, Yao H, Wang X, Tian Q, Tian F. 2024a. Transformer-based spatio-temporal traffic prediction for access and metro networks. Journal of Lightwave Technology 42(15):5204-5213. [This reference was for AVs, not relevant for the new article topic. Removed.]
Wymann B, Espié E, Guionneau C, Dimitrakakis C, Coulom R, Sumner A. 2000. TORCS, the open racing car simulator. Software. 4(6):2. [This reference was for AVs, not relevant for the new article topic. Removed.]
Xiao B, Guo J, He Z. 2021. Real-time object detection algorithm of autonomous vehicles based on improved YOLOV5S. [This reference was for AVs, not relevant for the new article topic. Removed.]
Xiao J, Ren Y, Du J, Zhao Y, Kumari S, Alenazi MJ, Yu H. 2024. CALRA: practical conditional anonymous and leakage-resilient authentication scheme for vehicular crowdsensing communication. IEEE Transactions on Intelligent Transportation Systems 99:1-13. [This reference was for AVs, not relevant for the new article topic. Removed.]
Xiao Z, Shu J, Jiang H, Min G, Chen H, Han Z. 2023. Overcoming occlusions: perception task-oriented information sharing in connected and autonomous vehicles. IEEE Network 37(4):224-229. [This reference was for AVs, not relevant for the new article topic. Removed.]
Xu P, Lan D, Yang H, Zhang S, Kim H, Shin I. 2025. Ship formation and route optimization design based on improved PSO and DP algorithm. IEEE Access 13:15529-15546. [This reference was for AVs, not relevant for the new article topic. Removed.]
Yang J, Yang K, Xiao Z, Jiang H, Xu S, Dustdar S. 2023. Improving commute experience for private car users via blockchain-enabled multitask learning. IEEE Internet of Things Journal 10(24):21656-21669. [This reference was for AVs, not relevant for the new article topic. Removed.]
Yao Y, Shu F, Cheng X, Liu H, Miao P, Wu L. 2023. Automotive radar optimization design in a spectrally crowded V2I communication environment. IEEE Transactions on Intelligent Transportation Systems 24(8):8253-8263. [This reference was for AVs, not relevant for the new article topic. Removed.]
Yue W, Li J, Li C, Cheng N, Wu J. 2024. A channel knowledge map-aided personalized resource allocation strategy in air-ground integrated mobility. IEEE Transactions on Intelligent Transportation Systems 25(11):18734-18747. [This reference was for AVs, not relevant for the new article topic. Removed.]
Zeng H-B, Zhu Z-J, Peng T-S, Wang W, Zhang X-M. 2024. Robust tracking control design for a class of nonlinear networked control systems considering bounded package dropouts and external disturbance. IEEE Transactions on Fuzzy Systems 32(6):3608-3617. [This reference was for AVs, not relevant for the new article topic. Removed.]
Zheng Y, Zhang Y, Ran B, Xu Y, Qu X. 2020. Cooperative control strategies to stabilise the freeway mixed traffic stability and improve traffic throughput in an intelligent roadside system environment. IET Intelligent Transport Systems 14(9):1108-1115. [This reference was for AVs, not relevant for the new article topic. Removed.]
Zhou Z, Wang Y, Zhou G, Liu X, Wu M, Dai K. 2024. Vehicle lateral dynamics-inspired hybrid model using neural network for parameter identification and error characterization. IEEE Transactions on Vehicular Technology 73(11):16173-16186. [This reference was for AVs, not relevant for the new article topic. Removed.]
Zhou Z, Wang Y, Zhou G, Nam K, Ji Z, Yin C. 2023. A twisted gaussian risk model considering target vehicle longitudinal-lateral motion states for host vehicle trajectory planning. IEEE Transactions on Intelligent Transportation Systems 24(12):13685-13697. [This reference was for AVs, not relevant for the new article topic. Removed.]
Zhu X, Luo Y, Liu A, Xiong NN, Dong M, Zhang S. 2021. A deep reinforcement learning-based resource management game in vehicular edge computing. IEEE Transactions on Intelligent Transportation Systems 23(3):2422-2433. [This reference was for AVs, not relevant for the new article topic. Removed.]
S Hutton (2019) Eye Tracking Methodology. Eye Movement Research. [Renumbered to 43]
N Valliappan et al. (2020) “Accelerating eye movement research via accurate and affordable smartphone eye tracking,” Nat Commun, 11. [Renumbered to 44]
É Lavoué, B Monterrat, M Desmarais, S George (2019) “Adaptive Gamification for Learning Environments,” IEEE Transactions on Learning Technologies, 12: 16-28. [Renumbered to 45]
G Borotic, T Jagušt (2022) “Enhancing student engagement with personalized gamification and adaptive learning strategies,” 2022 IEEE Frontiers in Education Conference (FIE) 1-5. [Renumbered to 46]
M Argilés, L Jurado, L Junyent (2020) “Gamification, serious games and action video games in optometry practice,” J Optom, 13: 210-1. [Renumbered to 47]
A Kurent, D Kosec (2022) “Review of vision screening referrals in children,” Slovenian Medical Journal. [Renumbered to 48]
Z Zainuddin, S Chu, M Shujahat, C Perera (2020) The impact of gamification on learning and instruction: A systematic review of empirical evidence. Educational Research Review. [Renumbered to 49]
K Nand, N Baghaei, J Casey, B Barmada, F Mehdipour, H Liang (2019) “Engaging children with educational content via Gamification,” Smart Learning Environments, 6. [Renumbered to 50]
M Hassan, U Habiba, F Majeed, M Shoaib (2019) “Adaptive gamification in e-learning based on students’ learning styles,” Interactive Learning Environments, 29: 545-65. [Renumbered to 51]
MA Abd Razak et al. (2019) “Validity of screening tools for dementia and mild cognitive impairment among the elderly in primary health care: a systematic review,” Public Health, 169: 84-92. [Renumbered to 52]
S Gray, C Bevan, S Campbell, K Cater (2021) “Space Vision,” in Proceedings of the ACM on Human-Computer Interaction, 5: 1-27. [Renumbered to 53]
V Pueyo et al. (2020) “Development of a system based on artificial intelligence to identify visual problems in children: study protocol of the TrackAI project,” BMJ Open, 10. [Renumbered to 54]
Q Ali, I Heldal, C Helgesen (2021) “A Bibliometric Analysis and Visualization of the Use of Eye-tracking Technologies for Vision Screening,” in 2021 International Conference on e-Health and Bioengineering (EHB), 1-4. [Renumbered to 55]
J Thompson, J Martinez, A Sarıkaya, E Cutrell, B Lee (2023) “Chart Reader: Accessible Visualization Experiences Designed with Screen Reader Users,” in Proceedings of the 2023 CHI Conference on Human Factors in Computing Systems. [Renumbered to 56]
C Kearney-Volpe, A Hurst (2021) “Accessible Web Development,” ACM Transactions on Accessible Computing (TACCESS), 14: 1-32. [Renumbered to 57]
M Fried-Oken, M Kinsella, B Peters, B Eddy, B Wojciechowski (2020) “Human visual skills for brain-computer interface use: a tutorial,” Disabil Rehabil Assist Technol, 15: 799-809. [Renumbered to 58]
R Soans et al. (2021) “Patients Prefer a Virtual Reality Approach Over a Similarly Performing Screen-Based Approach for Continuous Oculomotor-Based Screening of Glaucomatous and Neuro-Ophthalmological Visual Field Defects,” Front Neurosci, 15. [Renumbered to 59]
J Wentz, E Wentz, S Pierce (2023) “Preliminary assessment of a standardized vision screening guideline in a pediatric inpatient rehabilitation unit,” J Pediatr Rehabil Med. [Renumbered to 60]
Q Ali et al. (2020) “Eye-tracking Technologies Supporting Vision Screening In Children,” in 2020 11th IEEE International Conference on Cognitive Infocommunications (CogInfoCom), 0008: 447-71. [Renumbered to 61]
L González-Vides, J Hernández-Verdejo, P Cañadas--Suárez (2023) “Eye Tracking in Optometry: A Systematic Review,” J Eye Mov Res, 16. [Renumbered to 62]
T Tang et al. (2021) “ColourSpot, a novel gamified tablet-based test for accurate diagnosis of color vision deficiency in young children,” Behav Res Methods, 54: 1148-60. [Renumbered to 63]
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