283,000
Pediatric ED visits a year
Average annual U.S. emergency department visits by children under 18 for a sports- or recreation-related traumatic brain injury, 2010–2016. Contact sports accounted for approximately 45% of these visits.1
Premium all-in-one assessment · Research-use prototype
A comprehensive mTBI/concussion assessment system*
*For research use. Results are interpreted by a physician or medical assistant; not a diagnostic device.
SidelineOcular, from SidelineNeuro, unites instrumented near-IR eye tracking and a computerized neurocognitive battery in one integrated system. A force plate is included with the Clinic + Rehab setup.
Software output is suggestive only.
By the numbers
Concussion in sports, by the numbers
Concussions and other mild traumatic brain injuries occur in sport and in other settings, including falls, vehicle collisions, and workplace injuries. The figures below come from published sports and recreation surveillance. Football accounts for a large share of cases in those studies, and rates are also high in sports such as girls’ soccer and ice hockey. The figures describe what the researchers observed; they are not a determination about any individual patient, and they do not predict any individual’s risk.
Football, in the same CDC estimate
53,657
Football-related visits a year
Average annual visits associated with football — the highest of any activity in the report (95% CI, 42,998–64,316). Among other team sports, basketball accounted for 29,675 visits and soccer for 23,847.1
Highest high school rate
10.40
Per 10,000 high school football exposures
Concussion rate in high school football in High School RIO, 2013–2014 to 2017–2018 — the highest among 20 sports. Girls’ soccer was next at 8.19, followed by boys’ ice hockey at 7.69. The overall rate across those sports was 4.17.2
2.22×
Higher rate in girls, same sports
In sex-comparable high school sports (including soccer and basketball), the concussion rate was 3.35 per 10,000 athlete-exposures in girls versus 1.51 in boys (injury rate ratio 2.22; 95% CI, 2.07–2.39).2
47.3%
Reported their concussion
In a survey of 1,532 high school football players, 15.3% said they had sustained a concussion that season; of those, only 47.3% reported the injury. The most common reason for not reporting was not thinking it was serious enough (66.4%).3
31.0%
Symptoms still present at 28 days
In a multicenter study of children ages 5 to 17 seen in the emergency department after concussion, 801 of 2,584 who completed follow-up (31.0%) had persistent postconcussion symptoms at 28 days.4
Selected high school concussion rates
Rates are reported concussions per 10,000 athlete-exposures (one athlete in one practice or competition) from High School RIO, academic years 2013–2014 through 2017–2018.2
| Sport | Rate | CompetitionComp. | PracticePrac. |
|---|---|---|---|
| Football | 10.40 | 35.82 | 5.01 |
| Girls’ soccer | 8.19 | 21.80 | 2.14 |
| Boys’ ice hockey | 7.69 | 19.51 | 1.20 |
| Boys’ lacrosse | 4.92 | 13.04 | 1.46 |
| Girls’ basketball | 4.85 | 12.10 | 1.55 |
| Boys’ wrestling | 4.83 | 9.92 | 3.12 |
| Girls’ lacrosse | 4.22 | 10.01 | 1.66 |
| Boys’ soccer | 3.57 | 9.34 | 1.04 |
| Boys’ basketball | 2.12 | 4.11 | 1.24 |
In NCAA injury surveillance from 2009–2010 to 2013–2014, the highest concussion rates were in men’s wrestling (10.92 per 10,000 athlete-exposures), men’s ice hockey (7.91), women’s ice hockey (7.50), and men’s football (6.71). Men’s football had the largest estimated number of reported concussions each year (3,417).5 In a later NCAA period, 2014/15–2018/19, the overall rate was 4.13 per 10,000 athlete-exposures, with the highest rates in men’s ice hockey (7.35) and women’s soccer (7.15).6
Why early assessment and early rehab matter
Early assessment and evaluation by a qualified clinician can help identify people who should be removed from activity and referred for further care. In published studies of sport-related concussion, continuing to play after a concussion has been associated with longer recovery.
In a study of 69 athletes ages 12–19, those who continued to play after a sport-related concussion took nearly twice as long to recover as those who were removed immediately — a mean of 44.4 days versus 22.0 days — and were 8.80 times as likely to have a protracted recovery of 21 days or more.7 In 97 college athletes, delayed reporting and removal was associated with an average of 4.9 additional days before clearance, and about 2.2 times the likelihood of a recovery lasting eight days or more.8
Once a concussion has been evaluated by a clinician, early care is not the same as prolonged strict rest. A randomized trial of 103 adolescents found that individualized aerobic exercise below the threshold that worsened symptoms, started in the first week after injury, was associated with a median recovery of 13 days, compared with 17 days in a stretching comparison group.9 The Amsterdam 2022 International Consensus Statement on Concussion in Sport states that recommending strict rest until symptoms fully resolve is not beneficial. Relative rest, including daily activities and reduced screen time, is indicated for up to the first two days, and light-intensity activity such as walking may be appropriate during that period if it does not more than mildly worsen symptoms.10 These findings inform clinical practice; they are not a treatment plan, and rehabilitation decisions belong to a licensed clinician.
Where eye-movement and balance measurement fits
Vestibular and ocular-motor problems are commonly described after concussion. In one specialty-clinic sample of 100 adolescents evaluated after concussion, 69% had one or more vision diagnoses, including convergence insufficiency in 49%.11 A brief vestibular/ocular motor screening examination (VOMS) was developed to help clinicians assess these impairments alongside other parts of a clinical evaluation.12
SidelineOcular is a research-use prototype being developed to support research into objective eye-movement and balance measures. It is not a diagnostic device and is not a substitute for evaluation by a physician or medical assistant.
SidelineOcular is intended for research use only. It is not a medical device and is not a diagnostic device. It is not a substitute for evaluation by a licensed clinician. Software output is suggestive only.
References
- Sarmiento K, Thomas KE, Daugherty J, et al. Emergency Department Visits for Sports- and Recreation-Related Traumatic Brain Injuries Among Children — United States, 2010–2016. MMWR. 2019;68(10):237–242. cdc.gov/mmwr/volumes/68/wr/mm6810a2.htm
- Kerr ZY, Chandran A, Nedimyer AK, Arakkal A, Pierpoint LA, Zuckerman SL. Concussion Incidence and Trends in 20 High School Sports. Pediatrics. 2019;144(5):e20192180. pubmed.ncbi.nlm.nih.gov/31615955
- McCrea M, Hammeke T, Olsen G, Leo P, Guskiewicz K. Unreported concussion in high school football players: implications for prevention. Clin J Sport Med. 2004;14(1):13–17. pubmed.ncbi.nlm.nih.gov/14712161
- Zemek R, Barrowman N, Freedman SB, et al. Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED. JAMA. 2016;1014–1025. doi:10.1001/jama.2016.1203. pubmed.ncbi.nlm.nih.gov/26954410
- Zuckerman SL, Kerr ZY, Yengo-Kahn A, Wasserman E, Covassin T, Solomon GS. Epidemiology of Sports-Related Concussion in NCAA Athletes From 2009-2010 to 2013-2014: Incidence, Recurrence, and Mechanisms. Am J Sports Med. 2015;2654–2662. pubmed.ncbi.nlm.nih.gov/26330572
- Chandran A, Boltz AJ, Morris SN, et al. Epidemiology of Concussions in National Collegiate Athletic Association (NCAA) Sports: 2014/15-2018/19. Am J Sports Med. 2022;526–536. pubmed.ncbi.nlm.nih.gov/34898299
- Elbin RJ, Sufrinko A, Schatz P, et al. Removal From Play After Concussion and Recovery Time. Pediatrics. 2016;138(3):e20160910. pmc.ncbi.nlm.nih.gov/articles/PMC5005026
- Asken BM, McCrea MA, Clugston JR, Snyder AR, Houck ZM, Bauer RM. “Playing Through It”: Delayed Reporting and Removal From Athletic Activity After Concussion Predicts Prolonged Recovery. J Athl Train. 2016;51(4):329–335. ncbi.nlm.nih.gov/pmc/articles/PMC4874376
- Leddy JJ, Haider MN, Ellis MJ, et al. Early Subthreshold Aerobic Exercise for Sport-Related Concussion: A Randomized Clinical Trial. JAMA Pediatr. 2019;319–325. pmc.ncbi.nlm.nih.gov/articles/PMC6450274
- Patricios JS, Schneider KJ, Dvorak J, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport–Amsterdam, October 2022. Br J Sports Med. 2023;57(11):695–711. bjsm.bmj.com/content/57/11/695
- Master CL, Scheiman M, Gallaway M, et al. Vision Diagnoses Are Common After Concussion in Adolescents. Clin Pediatr (Phila). 2016;260–267. pubmed.ncbi.nlm.nih.gov/26156977
- Mucha A, Collins MW, Elbin RJ, et al. A Brief Vestibular/Ocular Motor Screening (VOMS) Assessment to Evaluate Concussions: Preliminary Findings. Am J Sports Med. 2014;2479–2486. pmc.ncbi.nlm.nih.gov/articles/PMC4209316
What it is
Three research-use tools, used together
SidelineOcular unites headset-based near-IR eye tracking and a computerized neurocognitive battery in a session that a physician or medical assistant can administer. It is offered in three setups: SidelineOcular Sideline, SidelineOcular Clinic, and SidelineOcular Clinic + Rehab. The force plate is included with Clinic + Rehab.
SidelineOcular headset
A precision-engineered headset with dual side-mounted near-IR cameras and hot mirrors. It is designed for short oculomotor tasks — typically 90 to 120 seconds — including smooth pursuit, saccades, and blinks.
Neurocognitive battery
A browser-based neurocognitive battery that can be administered as part of the same session, so recorded cognitive and eye-movement data can be reviewed together.
Balance force plate
Included with SidelineOcular Clinic + Rehab. A wireless force plate that records center-of-pressure sway — a more precise measure of postural sway than phone motion sensors — adding objective balance measurements to the session.
Products
Three setups, one system
SidelineOcular is offered in three research-use setups, from a short point-of-care session to a full in-office assessment battery and a rehab-tracking option. Tests are administered and interpreted by a physician or medical assistant. Software output is suggestive only.
Images shown are concept renderings; the hardware is in development.
Sidelines, events, and point of care
SidelineOcular Sideline
Goggles plus a phone app for a quick assessment subset of about 3–4 minutes (180–240 seconds), for sidelines, events, and point of care.
- Dual near-IR eye-tracking goggles
- Phone app In development
- Quick assessment subset, about 3–4 minutes (180–240 seconds)
In-office
SidelineOcular Clinic
Goggles plus a laptop or desktop, a chin rest, and a larger monitor, for the full assessment battery in the clinic.
- Dual near-IR eye-tracking goggles, laptop or desktop, chin rest, and a larger monitor
- The full assessment battery: oculomotor, VOMS-style, cognitive, balance, and symptoms
- Optional VNG-style vestibular module: optokinetic testing, nystagmus with vision removed, head-shake, subjective visual vertical, dynamic visual acuity, and VOR cancellation
In-office, with rehab tracking
SidelineOcular Clinic + Rehab
Everything in SidelineOcular Clinic, plus the force plate and a rehab and recovery tracking module.
- Everything in SidelineOcular Clinic
- Force plate for center-of-pressure balance testing
- Rehab and recovery tracking module In development: daily symptom diary on the phone, a progress dashboard against the person’s own baseline, short progress re-tests, home exercise programs with before-and-after symptom ratings and adherence tracking, exercise-tolerance and heart-rate logs, and clinician progress reports
Why one integrated system
Three instrumented modalities, in one session
SidelineOcular is designed so a physician or medical assistant can record eye-movement, cognitive, and balance data together, rather than piecing those measures together after the fact.
Instrumented near-IR eye tracking
A head-mounted headset with dual side-mounted near-IR cameras and hot mirrors records oculomotor tasks such as smooth pursuit, saccades, and related eye-movement measures.
Computerized neurocognitive battery
A browser-based battery of memory, attention, processing-speed, and reaction-time tasks can be administered in the same session, so recorded cognitive and eye-movement data can be reviewed together.
Force-plate balance
A wireless force plate records center-of-pressure sway. Center-of-pressure measurement is more precise than phone motion sensors for describing postural sway.
Today, clinics and teams often assemble eye tracking, cognitive testing, and balance from separate products.
We have not identified another system that combines head-mounted near-IR eye tracking, a computerized neurocognitive battery, and force-plate balance in one unit (based on our review of 25 products, November 2026).
What the battery measures
A research-use battery of recorded measures
The current battery includes the measures below. Tests are administered and interpreted by a physician or medical assistant. Software output is suggestive only.
Oculomotor
- Calibration and recalibration check
- Fixation stability
- Anti-saccades
- Pupil / iris proxy
- A VOMS-style assessment, including:
- Smooth pursuit
- Horizontal and vertical saccades
- Near-point convergence, measured in centimeters over 3 trials
- Horizontal and vertical VOR
- Visual motion sensitivity
- Headache, dizziness, nausea, and fogginess ratings recorded before and after each part
Cognitive
- Orientation (Maddocks-style)
- Word memory (immediate and delayed)
- Visual / design memory (immediate and delayed)
- Concentration (digits and months reverse)
- Simple and choice reaction time
- Go/no-go
- Processing speed (symbol-digit)
- Trail-making style A and B
- Color-word interference (Stroop-style)
- Number naming
Balance
- mBESS (modified Balance Error Scoring System)
- Timed tandem gait
- Force-plate quiet stance, eyes open and eyes closed, recording center of pressure (SidelineOcular Clinic + Rehab)
Symptoms
- 12-item symptom checklist (0–10)
- Red-flag / danger-sign checklist
Vestibular
An optional VNG-style module, available with SidelineOcular Clinic and Clinic + Rehab.
- Optokinetic testing
- Nystagmus with vision removed
- Head-shake
- Subjective visual vertical
- Dynamic visual acuity
- VOR cancellation
Reporting
Reports are prepared for review by a physician or medical assistant. Software output is suggestive only. A report can include:
- Comparison to the person’s own baseline, with a practice-adjusted change score
- Effort and validity review flags
- Domain composite scores for memory, processing speed, reaction time, and executive/attention
- Rotating alternate forms, with scheduled re-baselining
In development
Rehab and recovery tracking
Available with SidelineOcular Clinic + Rehab. This module is in development. It is designed so a physician or medical assistant can review recorded progress. Software output is suggestive only. It is intended to measure and track recovery, and includes:
- Daily symptom diary on the phone
- Progress dashboard against the person’s own baseline
- Short progress re-tests
- Home exercise programs with before-and-after symptom ratings and adherence tracking
- Exercise-tolerance and heart-rate logs
- Clinician progress reports
In development
Planned additions
These items are planned and are not part of the current battery.
- Phone app (Sideline setup)
- 22-item symptom scale
- Foam mCTSIB
- Limits of stability
How it works
A session led by a clinician
A physician or medical assistant administers the session and reviews the recorded data. Software output is suggestive only.
Set up at the point of care
Place the headset and open the task battery. When using SidelineOcular Clinic + Rehab, ready the force plate. The system is designed for the office, the sideline, events, urgent care, and other point-of-care settings.
Run the task battery
Oculomotor tasks typically take about 90–120 seconds. Cognitive and balance measurements can be included in the same session.
Review recorded data with the clinician
Eye-movement, cognitive, and balance recordings are available for the physician or medical assistant to review. Software output is suggestive only.
Who it is for
Built for doctors and clinicians
SidelineOcular is being developed as a general-use, research-use assessment system for physicians, clinicians, and other licensed professionals — in the clinic, at the point of care, and on the sideline. It is not limited to sports teams.
- Primary care
- Neurology
- Sports medicine
- Urgent care and emergency medicine
- Physical therapy
- Chiropractic
- Pediatrics
- Occupational health
- Athletic trainers and teams
Researchers studying oculomotor, cognitive, and balance measurements may also be interested in collaborating.
Development status
Prototype stage, seeking research partners
SidelineOcular is in the prototype stage and is intended for research use. SidelineNeuro is seeking research and validation partners. If you are interested in collaborating, we would like to hear from you.
Start a conversationContact
Get in touch
Reach out about research collaborations, prototype access, or general questions.
- Email [email protected]
- Phone 801‑550‑4484
- Location Utah, USA
- Founder Terry Willardson