A novel wearable device for the quantitative assessment of eye movement in Ocular Myasthenia Gravis (OMG): an exploratory engineering feasibility study

Ocular Myasthenia Gravis (OMG) is an autoimmune disorder characterized by fatigable weakness of the extraocular muscles. We conducted a non-clinical, exploratory engineering feasibility study to evaluate a low-cost, wearable eye-tracking device (“OMG-glasses”) for quantitative characterization of ocular motility in OMG. To our knowledge, no wearable eye-tracking system has been specifically developed for OMG. Sixteen participants (eight clinically diagnosed OMG patients and eight healthy controls) performed a standardized gaze task while eye movements were recorded using a spectacle-mounted infrared camera. Custom software extracted trajectory-based ocular motility metrics. Compared with controls, OMG patients demonstrated significantly reduced horizontal (H) and vertical (V) gaze range and total path length, with vertical gaze being disproportionately reduced relative to horizontal gaze. The combination of a significant non–duration-normalized H:V ratio with a non-significant duration-normalized H:V ratio between the OMG and control groups indicated that this pattern itself may serve as an indicator of ocular motility deficit, rather than fatigue acting merely as a confounding factor. This pilot study has important limitations, including small sample size, unilateral assessment, and approximate calibration, and did not evaluate diagnostic accuracy. These findings demonstrate proof-of-concept differentiation of ocular motility patterns between known OMG patients and healthy controls and support further validation in larger, controlled studies.