Evaluating Simulated Skew Deviation with a Smartphone Eye-Tracking Tool (EyePhone): A Feasibility Assessment
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By
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Rajvi Babaria
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Pouya Barahim Bastani
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Hector Rieiro
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Shervin Badihian
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Jorge Otero-Millan
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Ali Saber Tehrani
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July 21, 2026
Clinical Scorecard: Evaluating Simulated Skew Deviation with a Smartphone Eye-Tracking Tool (EyePhone): A Feasibility Assessment
At a Glance
| Category | Detail |
|---|
| Condition | Skew Deviation |
| Key Mechanisms | Detection of vertical ocular misalignment indicative of vestibular causes, particularly in stroke. |
| Target Population | Healthy volunteers without known vestibular or ocular motor disorders. |
| Care Setting | Emergency Department |
Key Highlights
- HINTS eye exam improves diagnostic accuracy for vestibular strokes with 98% sensitivity and 97% specificity.
- Skew deviations of >5 diopters are highly specific for stroke.
- EyePhone shows a Spearman correlation of 0.93 for detecting skew deviations.
- Area under the ROC curve for discriminating skews ≥5 diopters is 0.90.
- Smartphone technology may enhance accessibility for eye movement analysis.
Guideline-Based Recommendations
Diagnosis
- Utilize the HINTS eye exam to differentiate between peripheral and central causes of acute vestibular syndrome.
Management
- Further validation of EyePhone in clinical groups is necessary before clinical implementation.
Monitoring & Follow-up
- Monitor eye movements for signs of skew deviation in patients presenting with dizziness.
Risks
- Misdiagnosis of strokes presenting with dizziness due to subtlety in skew deviation detection.
Patient & Prescribing Data
Healthy volunteers aged 18 and older.
EyePhone application may serve as a practical tool for detecting clinically significant skew deviation.
Clinical Best Practices
- Incorporate smartphone-based eye tracking in emergency settings for improved assessment of vestibular disorders.
- Ensure proper calibration and recording conditions when using EyePhone for eye movement analysis.
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