Enhancing Brain Health and Human Performance with Eye Tracking
In their presentation at Varjo Live, the team from MachineMD, a Swiss med-tech innovator, outlined how advanced eye tracking technology (powered by the a Varjo VR headset) can be used to redefine the landscape of brain diagnostics and performance analytics. Their groundbreaking solution, NEOS, introduces the next frontier of oculomics: using the eyes to reveal deep insights about the brain.
Below is a recording and a summary of the key takeaways from the session.
MachineMD and the Rise of Oculomics
Mission and Challenge
MachineMD, based in Bern, Switzerland, is on a mission to democratize access to neurodiagnostics. Nearly 43% of the global population lives with a neurological disorder, yet current diagnostic tools like MRI and CT scans are costly, inaccessible, and often require long waiting times, up to three years in non-urgent cases in the UK.
Introducing NEOS
To address this, MachineMD has developed NEOS: a fast, non-invasive, and certified medical device that evaluates brain function through eye and pupil reactions to visual stimuli.
NEOS is a diagnostic device built on the Varjo Aero virtual reality headset, which features a high-precision, built-in eye tracker.
By leveraging Varjo’s industry-leading eye-tracking technology, NEOS enables fast, non-invasive assessments of brain function through detailed analysis of eye and pupil responses.
With NEOS, clinicians can detect neurological conditions earlier; an essential capability in emergencies like strokes or brain tumors where time is critical.
Why Eyes Matter
As a large portion of the brain governs visual processing and eye movement, subtle anomalies in how eyes and pupils respond can point to deeper issues. NEOS captures these biomarkers with greater precision than manual tests reducing testing time from 50 minutes to just 3. This increases diagnostic accuracy and drastically helps to lower misdiagnosis rates.
These biomarkers are computed from eye features, such as pupil size, saccades, and fixations, precisely tracked by the built-in Varjo eye tracker, which plays a critical role in enabling reliable neurodiagnostic insights.
Varjo-Powered Accuracy
NEOS is built on the Varjo Aero headset, selected specifically for its high-frequency 200Hz eye tracking; a level of fidelity unmatched by typical 60Hz or 90Hz trackers. This collaboration marks the first certified medical device based on a VR headset and sets a new standard for eye-tracking quality in clinical settings.
Technician-Friendly and Scalable
Thanks to NEOS, technicians (not just neuro-ophthalmologists) can now conduct reliable brain screenings, helping to close the gap in access to specialized care.
From Flashlights to Algorithms: Rethinking RAPD Screening
Digitalizing the Classic Flashlight Test
Bruno Hauer, MachineMD’s Head of Analytics, explored how NEOS digitally simulates the classical swinging flashlight test used to detect Relative Afferent Pupillary Defect (RAPD), which is used as a key indicator of optic nerve disorders.
Traditional methods suffer from subjectivity, lighting inconsistencies, and poor repeatability. NEOS replaces the flashlight with controlled visual stimuli and captures pupil reaction traces using Varjo’s eye tracker. The data is then processed through rigorous algorithms to compute a quantitative NEOS Score, benchmarked against a normative database of healthy subjects.
Clinical Validation
In a cohort of 165 patients (40 diagnosed with RAPD), the NEOS Score achieved an AUC of 0.82, demonstrating strong predictive power for detecting optic nerve anomalies with far greater objectivity and reliability.
Applying Medical Eye Tracking in Simulation and Training
Cognitive Load in Pilot Training
Patrick Wyatt, Varjo’s Chief Brand Officer, and Dominic Bruger, MachineMD’s CTO, illustrated how eye tracking is now being adapted for simulation training, especially for civil and military pilots.
Metrics like pupil dilation, fixation duration, blink rate, and saccadic movement reveal a participant’s cognitive workload, stress level, and attention allocation. These measurements provide training professionals with actionable insights into performance allowing them to optimize training design and ensure pilots are focusing on the right instruments and areas in high-stakes scenarios.
Advantages of VR in Analytics
VR offers total control over ambient light and visual environment for distinguishing between stress-induced changes and lighting artifacts. While more invasive approaches like EEG are an option, eye tracking stands out for being non-intrusive, easy to set up, and scalable.
Rejecting Oversimplification
Rather than consolidating all metrics into a single stress score, MachineMD advocates for task-specific interpretations to ensure insights are relevant and context-aware.
Q&A Highlights: Scaling Science with Precision
Medical Device Regulation
NEOS is a Class II medical device, requiring rigorous certification from notified bodies in the EU and FDA in the US, including usability testing and comprehensive documentation.
VR Acceptance and Design
MachineMD’s studies show high acceptance of VR headsets, even among elderly and pediatric patients. Special attention is given to preventing nausea and ensuring intuitive headset positioning.
Reliability and Edge Cases
The team shared that eyeglasses, dark irises, and droopy eyelids can present challenges for eye-tracking systems. Nonetheless, Varjo’s high-resolution and robust tracking pipeline continues to prove resilient across diverse user profiles.
Beyond Neurology?
While MachineMD’s primary focus is on neurological diagnostics, they are exploring partnerships to extend their validated methodologies into mental health, cognitive performance, and simulation-based assessments.
From Clinical Rigor to Real-World Impact
This session underscored a powerful message: high-performance eye tracking isn’t just about seeing where someone is looking. It’s about understanding what their brain is doing. Whether diagnosing multiple sclerosis or assessing cognitive workload in a flight simulator, the fusion of Varjo’s hardware and MachineMD’s analytics opens doors to earlier detection, smarter training, and more human-centered technology.
Watch the full session from Varjo Live here: MachineMD Presentation