# Quantitative patterns of visual impairment and recovery in children with brain injury

## TL;DR

A new interactive tool called the Visual Ladder helps measure visual impairments in children with brain injuries, revealing recovery patterns and diagnostic clusters.

## Contribution

The Visual Ladder provides a novel, game-like, gaze-based method to quantify visual impairments in children with brain injuries.

## Key findings

- The tool measures eye movements, field asymmetries, and contrast sensitivity in hospitalized children.
- Certain visual abilities show higher likelihoods of recovery after brain injury.
- Task outcomes define unique diagnostic clusters of visual impairment.

## Abstract

Brain injury can cause many distinct types of visual impairment in children, but these deficits are difficult to quantify due to co-morbid deficits in communication and cognition. Clinicians must instead rely on low-resolution, subjective judgements of simple reactions to handheld stimuli, which limits treatment potential. We have developed an interactive assessment program called the Visual Ladder, which uses gaze-based responses to intuitive, game-like tasks to address the lack of broad-spectrum quantified data on the visual abilities of children with brain injury. Here, we present detailed metrics on eye movements, field asymmetries, contrast sensitivity, and other critical visual abilities measured longitudinally using the Ladder in hospitalized children with varying types and degrees of brain injury, many of whom were previously considered untestable. Our findings show which abilities are most likely to exhibit recovery and reveal how distinct patterns of task outcomes defined unique diagnostic clusters of visual impairment.