Embedding an Eye Tracker Into a Surgical Microscope: Requirements, Design, and Implementation

Eye tracking has long been known as a tool for attention tracking, however, the understanding of gaze in the critical domains such as surgery is still in its infancy. In image-guided surgery, studying the role that visual attention plays in eye-hand coordination, situation awareness, and instrumentation control is critical in order to understand the nature of expertise and explore the possibilities for gaze-based interaction. To date, the eye-tracking technology has not been embedded into an operation room microscope and thus limited knowledge is available about the role of attention in real-life image-guided surgery. To advance the state-of-the-art, we adopted an optical solution for eye tracking and embedded a binocular eye tracker into a surgical microscope. We present the design principles and development evaluation cycles, as well as highlight the technical challenges encountered when embedding an eye tracker for a surgical microscope. The developed solution can be applied for other types of microscopes and ocular-based optical devices, for example, ophthalmology, otolaryngology, plastic and reconstructive surgery, and astronomical devices.