To explore the use of portable eye-tracking devices in detecting cognitive impairment in neurological disorders, particularly in multiple sclerosis (MS), and evaluate their reliability in clinical settings.

Eye-tracking technology is increasingly recognized as a valuable tool for assessing ocular motor function and cognitive processes in various neurological conditions, including mild traumatic brain injury, autism spectrum disorder, schizophrenia, attention deficit hyperactivity disorder, and neurodegenerative diseases like Alzheimer's and Parkinson's disease. Historically, eye-tracking technology was limited to research due to expensive and complex equipment. However, recent advancements have led to the development of portable and accessible devices, making them applicable in diverse clinical settings for studying cognitive function.

A systematic review and meta-analysis were performed in accordance with PRISMA guidelines. Eight Observational studies using portable eye-tracking devices were included. Databases searched included PubMed, Embase, and Cochrane, with studies screened and reviewed by two independent authors. Outcomes assessed were eye movements and visual responses in neurological patients. The Critical Appraisal Skills Programme (CASP) checklist was used to assess study quality and bias.

A total of 62 studies were identified, with 8 included after screening. This review highlights the growing use of eye-tracking technology in neurology, emphasizing its value in cognitive research by assessing attention, memory, and decision-making through eye movements. Studies focused on saccades, smooth pursuit, and antisaccades reveal insights into neurological conditions like multiple sclerosis, Parkinson’s, schizophrenia, autism, and traumatic brain injury. Portable eye-tracking devices offer practical, high-frequency data collection, facilitating real-time assessments in clinical and research settings. These tools enhance diagnostic precision, promote early interventions, and expand opportunities for cognitive and neurological evaluations across various populations.

Portable eye-tracking devices show promise for detecting cognitive impairments in neurological conditions like MS. Their portability  facilitate widespread clinical application, making cognitive assessments more accessible and effective in early diagnosis and monitoring of disease progression.