The Neurotriage Device

The device can run 15-20 eye tests on a subject in less than three minutes, including measures on pupil dilation, reaction time, target tracking, balance, and visual steadiness

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By Kyser Lough
Population Health Scholar
University of Texas System
PhD Student in Journalism
UT Austin Moody College of Communication


While serving in the Marine Corps, Dr. Robert Rennaker watched several of his friends suffer from traumatic brain injuries and realized modern medicine wasn’t equipped with the technology to help them fully recover from their injuries. After receiving an honorable discharge from the Marine Corps and going back to school, Rennaker began studying neural engineering. His goal was, and is, to become part of the solution to these problems

“I was seeing people with debilitating neurological injuries and realizing current modern medicine had very few solutions for them,” said Rennaker, Department Head of Bioengineering and Executive Director of the Texas Biomedical Device Center at The University of Texas at Dallas.

One of Rennaker’s current projects involves detecting when the brain has suffered physical trauma so that he and others can learn how to more effectively prevent or treat these injuries. Currently, the primary tools for diagnosing traumatic brain injuries are imaging and subjective eye tests that don’t provide enough precision. This means that subtle neurological changes from minor concussions or injuries can go undiagnosed. This scenario is dangerous on two fronts. A neurocognitively impaired person has slower reaction times and therefore is less capable of making fast decisions to avoid additional impacts, and an already injured brain is more vulnerable to damage in the event that another impact occurs.

“We want to detect impairment so we can get people out of harm’s way,” he said, “whether that’s on the street, the battlefield, or the athletic field. If people are impaired and can’t see what’s coming, they’re more likely to get injured.”

To better understand this, Rennaker and his team have developed the Neurotriage device, which can run 15-20 eye tests in less than three minutes, including measures of pupil dilation, reaction time, target tracking, balance and visual steadiness.

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The long-term goal is to be able to use the Neurotriage, which looks a bit like a souped-up pair of binoculars, to more accurately diagnose impairments and track recovery. In the short term, Rennaker and his colleagues are testing out the device in specific contexts, such as a football game, in which impacts are common. Players are tested on the Neurotriage before a game, before there’s been an impact, to get a baseline score. The players are equipped with an impact monitor that they wear during the game to alert the staff if they suffered a significant impact. If they’re hit hard enough, they go to the sideline to get re-tested on the Neurotriage. Any differences in their scores from the pre-game baseline can be indicative of an impairment or injury.  

“Head injury typically affects the visual system, which is highly integrated into all areas of the brain, and as a result is a very sensitive marker for brain injury or impairments,” Rennaker said. “The whole goal with this tool is to document what is normal with the individual and then document what changed after an injury or suspected impairment. It’s a very simple indicator that there’s been an assault to the nervous system.”

Rennaker sees this tool being useful in three arenas: sports, the military and road safety. When an athlete is injured, the device could potentially show the severity of the impairment and quantify slower reaction times of the player. Removing the player from the game until their reaction times normalize could potentially prevent further injury. The same thing could be applied to the military, where a soldier’s impairment could be measured to understand how his or her reaction time may be slowed on the battlefield. On the road, police could use the device to know how impaired a driver really is and how much danger they could be putting other drivers in, irrespective of what caused the impairment.

Rennaker has tested the device in a number of real world contexts, including with football players.  He is currently working to finalize a commercial device so that he can start building a consistent database of recorded data. Over time, he says, that should enable more and more refined measures.

“The cool thing with this system is that we can record and quantify these eye movements and document them,” he said. “We can use that data to solve societal challenges whether it’s concussions on the field or getting impaired drivers off the road so they don’t injure themselves and other people. I think in the future I’ll even be able to tell you what part of the brain was injured based on the changes I see in specific eye movements.”