Following a stroke, some patients lose awareness of one side of their environment, despite having no physical impairment of sight, hearing or touch. This condition, known as visuospatial neglect, can have a major impact on recovery and everyday life. A recent study conducted at the Department of Neurology and Neurorehabilitation at Lucerne Cantonal Hospital highlights the potential of video oculography – a non-invasive eye-tracking method – to detect neglect more reliably and at an earlier stage.

A hidden obstacle to recovery

People with visuospatial neglect often fail to notice objects, people or even parts of their own body on one side, most commonly the left side following a stroke affecting the right hemisphere of the brain. As a result, they may bump into obstacles or struggle to navigate their surroundings.

The condition can significantly affect rehabilitation outcomes. Patients with neglect often benefit less from therapy because they overlook part of their body or environment and are therefore unable to fully engage with exercises, aids or safety instructions. The risk of falls and injuries is also increased, while everyday activities such as dressing, eating or finding one’s way around become more challenging. Even when other physical or cognitive impairments improve, neglect can continue to limit a person’s independence.

Tracking eye movements to improve diagnosis

The Lucerne research team, led by Professor Dario Cazzoli together with Professor Thomas Nyffeler, Dr Brigitte C. Kaufmann and other contributors, investigated the use of video oculography to identify neglect. The technology records eye movements while patients view everyday images, making it possible to determine which areas receive attention and which are systematically overlooked.

Previous studies have shown that eye-tracking measurements correlate closely with difficulties encountered in everyday life and can detect neglect more reliably than conventional pen-and-paper tests. Because viewing images is a spontaneous activity, the method can also be used with patients who have speech or motor impairments following a stroke. Video oculography is already being used routinely in Lucerne and is increasingly being adopted by clinics in Switzerland and abroad.

A key feature of the study was that assessments were carried out within 72 hours of the stroke. The findings suggest that neglect can be identified much earlier than with traditional approaches, creating opportunities to begin targeted rehabilitation measures sooner and potentially shorten recovery times.

Research with direct clinical impact

The project also demonstrates the strengths of the Lucerne research environment, where close collaboration between the University of Lucerne and Lucerne Cantonal Hospital enables clinical practice, research and technological innovation to be closely linked.

Through this interdisciplinary approach, new diagnostic methods can be developed and tested directly with patients before being integrated into routine care. In neurorehabilitation, where medical, therapeutic and research expertise must work hand in hand, such collaboration helps ensure that scientific advances translate into tangible benefits for patients.

This article is based on “Augenbewegungen als Schlüssel” featured in the 2025 Annual Report.