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The purpose of this study was to assess the impact of elevated ICP on eye-tracking performed while patients were watching a short film clip.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Awake patients requiring placement of an ICP monitor for clinical purposes underwent eye tracking while watching a 220-second continuously playing video moving around the perimeter of a viewing monitor. Pupil position was recorded at 500 Hz and metrics associated with each eye individually and both eyes together were calculated. Linear regression with generalized estimating equations was performed to test the association of eye-tracking metrics with changes in ICP.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Eye tracking was performed at ICP levels ranging from \u22123 to 30 mm Hg in 23 patients (12 women, 11 men, mean age 46.8 years) on 55 separate occasions. Eye-tracking measures correlating with CN function linearly decreased with increasing ICP (p &lt; 0.001). Measures for CN VI were most prominently affected. The area under the curve (AUC) for eye-tracking metrics to discriminate between ICP &lt; 12 and \u2265 12 mm Hg was 0.798. To discriminate an ICP &lt; 15 from \u2265 15 mm Hg the AUC was 0.833, and to discriminate ICP &lt; 20 from \u2265 20 mm Hg the AUC was 0.889.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Increasingly elevated ICP was associated with increasingly abnormal eye tracking detected while patients were watching a short film clip. These results suggest that eye tracking may be used as a noninvasive, automatable means to quantitate the physiological impact of elevated ICP, which has clinical application for assessment of shunt malfunction, pseudotumor cerebri, concussion, and prevention of second-impact syndrome.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.12.jns161265","type":"journal-article","created":{"date-parts":[[2017,6,2]],"date-time":"2017-06-02T13:59:06Z","timestamp":1496411946000},"page":"811-818","source":"Crossref","is-referenced-by-count":6,"title":["Elevated intracranial pressure and reversible eye-tracking changes detected while viewing a film clip"],"prefix":"10.3171","volume":"128","author":[{"given":"Radek","family":"Kolecki","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, New York University School of Medicine, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikalpa","family":"Dammavalam","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hennepin County Medical Center and University of Minnesota, Minneapolis, Minnesota; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah","family":"Bin Zahid","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hennepin County Medical Center and University of Minnesota, Minneapolis, Minnesota; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Molly","family":"Hubbard","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hennepin County Medical Center and University of Minnesota, Minneapolis, Minnesota; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osamah","family":"Choudhry","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, New York University School of Medicine, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marleen","family":"Reyes","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, New York University School of Medicine, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ByoungJun","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, New York University School of Medicine, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, New York University School of Medicine, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paraskevi Vivian","family":"Papas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, New York University School of Medicine, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aylin","family":"Adem","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, New York University School of Medicine, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"North","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, New York University School of Medicine, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David T.","family":"Gilbertson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hennepin County Medical Center and University of Minnesota, Minneapolis, Minnesota; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas","family":"Kondziolka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, New York University School of Medicine, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason H.","family":"Huang","sequence":"additional","affiliation":[{"name":"Scott and White Healthcare, Temple, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul P.","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, New York University School of Medicine, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uzma","family":"Samadani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hennepin County Medical Center and University of Minnesota, Minneapolis, Minnesota; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Nig Q J Hosp Med","first-page":"252","article-title":"Hydrocephalus and the eyes: a teaching hospital experience","volume":"21","author":"Akinsola FB","year":"2011","unstructured":"Akinsola FB, Yusuf GF, Bankole OB, Kanu OO, Onakoya AO, Aribaba OT: Hydrocephalus and the eyes: a teaching hospital experience. 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