Their device promises faster and more accurate concussion assessments. A venture fund started by the Green Bay Packers took notice.

Jeff Bollier
Green Bay Press-Gazette
Uzma Samadani, founder of Oculogica.

GREEN BAY - A venture fund led by the Green Bay Packers and Microsoft has invested in a new technology that promises to provide a major advance in the diagnosis of concussions. 

TitletownTech, a business development partnership established last year by the Packers and Microsoft, confirmed Thursday that its venture-capital fund was the lead contributor to an $8 million investment in Oculogica Inc., a company led by two sisters who are lifelong Packers fans from Beaver Dam. 

The company produces a device called EyeBOX, a concussion assessment tool that can quickly detect brain injuries and help physicians rapidly classify the nature of those injuries.

The tabletop-sized EyeBOX has a video screen and chin rest where patients rest their heads. A person with concussion symptoms watches a nearly four-minute video while the device monitors their eye movements, then collects and analyzes more than 100,000 data points in order to determine if there's evidence of concussion damage and what type of damage the person sustained. The results are available right away.

"We think this is a game-changing technology," TitletownTech Managing Director Jill Enos said. 

Dr. Uzma Samadani founded Oculogica in 2013 after she discovered a correlation between impaired eye movements and brain injuries such as concussions. Rosina Samadani, Oculogica's CEO, worked with her sister to develop the EyeBOX device itself.

The Samadanis said EyeBOX marks a fundamental change in the way concussions are assessed and could lead to a better understanding of brain injuries. 

Dr. Ron Elfenbein, a physician in Gambrels, Maryland, at the time of the photo, shows off Oculogica's EyeBOX device. The EyeBOX conducts an eye test that can aid in the diagnosis of concussions while patients watch a four-minute video.

"Most other concussion tests are very subjective. People have different measurements for their own fatigue and pain. This removes the subjective components," Rosina Samadani said.

The U.S. Food and Drug Administration granted its approval for EyeBOX on Dec. 28, 2018. In October, the American Medical Association created a new Current Procedural Technology (CPT) Code that enables physicians to submit EyeBOX tests for reimbursement beginning in July. The FDA has only approved the device for use by physicians. It is not something the general public can purchase for use. 

TitletownTech's investment comes at a time when the NFL is grappling with increased concern about long-term effects of head injuries after it settled a lawsuit with former players for more than $1 billion in January 2017.  

Ed Policy, the Packers' chief operating officer and general counsel, said Oculogica fits with the Packers' and NFL's focus on player safety but could make an even greater impact far from professional sports.

"Player health and safety is obviously one of the most important concerns in the NFL, but concussions in particular are a major concern for athletes of all levels, the Department of Defense and the general population," Policy said. "One of the things we're trying to do is build scalable companies that can grow a lot over time. When you have millions of concussions reported annually, we think there will be a lot of customers for this technology." 

Uzma Samadani, founder of Oculogica, and Jill Enos, managing director of Titletown Tech, in a conference room in Titletown Tech in Green Bay.

'If you can measure it, you can treat it'

ThinkFirst, a national injury prevention firm, estimates there are 3.8 million concussions reported each year in the United States, with only a small fraction the result of sports injuries.

Adults older than 65 and children younger than 4 have the greatest risk of sustaining brain injuries, and that more than 70% of brain injuries requiring medical care result from either a fall or a vehicle crash, according to the U.S. Centers for Disease Control . 

Thanks to public awareness campaigns, parents and coaches no longer just tell their children or players that they "got their bell rung." Care providers no longer tell patients they'll get better if they stay in a dark room for a week. 

Yet concussion diagnosis and treatment still requires up to two hours of diagnostic tests, said Jason Terry, a licensed athletics trainer with Bellin Health Sports Medicine and Orthopedics Clinic.

Concussions can cause a wide variety of symptoms, which means patients must undergo a battery of tests that can be compared to their short- and long-term medical histories, Terry said. Only then can doctors determine what parts of the brain have been affected (motor skills, speech, cognition, etc.) and recommend appropriate treatment. 

The problem with diagnosing head traumas and brain injuries is the brain itself, Uzma Samadani said. Two people with equally severe symptoms may describe them differently, and two physicians may interpret those descriptions differently. 

What's needed, she said, is an objective measure.  

Jill Enos, managing director of Titletown Tech, left and Uzma Samadani, founder of Oculogica at Titletown Tech.

"If you can measure it, you can treat it," Uzma Samadani said. "Brain function is very, very difficult to measure. That's why medicine has so many problems with mental health disorders."

The EyeBOX provides such an objective measure, and in a fraction of the time, the Samadanis said. The test is completed in 220 seconds. 

Terry could not talk about the efficacy of Oculogica's device because he has no experience with EyeBOX, but he did say faster assessment of a brain injury could improve treatment outcomes.

"If we can get somebody with (balance) symptoms into therapy quicker, they do much better," he said.

'That was the breakthrough'

Oculogica was founded in 2013, but you have to go back to a Veterans Administration hospital in Manhattan in 2010 to find its start.

At the time, Uzma Samadani was researching ways to measure how patients in a persistent vegetative state, awake but unresponsive, were affected by visual stimuli such as watching TV or a researcher's eye contact.

When she tried those tests on patients in a neurosurgery clinic, she said a connection between brain injuries and restricted eye movement emerged. In August 2012, she tested a patient who came in reporting concussion symptoms after a fall.

"That's when I realized you could detect concussive symptoms based on restricted eye movement," she said. "We found people lacked the anatomical integrity to move their eyes in different patterns, that eye tracking could assess physiologic functions of the brain. That was the breakthrough."

It took a few years to refine the test, develop the technology and pull it all together in an early prototype of the EyeBOX device. SEC documents indicate Oculogica raised $600,000 from six investors in 2014. 

Rosina Samadani sensed her sister's excitement at the discovery, but said its implications escaped her until she joined Oculogica as its CEO in 2015. 

"I knew she had discovered something that made her so excited she was working on it night and day and not sleeping," Rosina Samadani said. "I understood it was a very big deal, but I didn't know there was no objective diagnostic for concussion already."

Oculogica Inc. CEO Rosina Samadani addresses Green Bay area business and community leaders at a TitletownTech press conference in October 2019. TitletownTech, a partnership between the Packers and Microsoft, made an investment in the company which is bringing a device to market that can look for concussion symptoms while patients watch a four-minute video.

Rosina Samadani said she improved the EyeBOX software, raised another $1.6 million from investors in 2016 and further refined the EyeBOX device into something more sleek and portable.

She also oversaw preparations for and oversight of the FDA study, conducted at six clinics including the Mayo Clinic and Beaver Dam Community Hospital, that resulted in FDA authorization to use the EyeBOX as an "aid in the diagnosis of concussion" in December 2018. 

As Oculogica progressed, Rosina Samadani sought additional help with bringing the EyeBOX to the health care market. It ended up coming from a team she's supported since she was 4.

'That's our team'

It's a little more than 94 miles, a less-than two hour drive, from Beaver Dam, Wisconsin to Lambeau Field. 

But the Samadani sisters' journey to the Packers took a little longer than that, as both made their way from northeastern Wisconsin to New York City. 

Uzma Samadani graduated from Wayland Academy in Beaver Dam in 1988 before attending the University of Wisconsin to study molecular biology. Her interest in treating brain injuries and specialties in neurosurgery led her to the University of Pennsylvania, Bellevue Hospital in New York City. She eventually became the chief of neurosurgery at the Manhattan Veterans Administration Hospital. 

In August 2015, Uzma Samadani took a job with the University of Minnesota, where she also worked for several years as a neuroscience consultant to the Minnesota Vikings. In late 2019, she joined CentraCare Neurosciences, though she remains a member of the University of Minnesota faculty. 

Rosina Samadani shared an interest in health care technology, but took a more  entrepreneurial path. She graduated from Wayland Academy in 1985 and went on to pursue degrees in mechanical and biomedical engineering. She ended up in New York City working for McKinsey & Company's health care consulting division before starting her own consulting firm in 2004. 

Oculogica was founded in New York in 2013 and remains headquartered there today. That's also where a previous investor in Oculogica mentioned to Rosina Samandani that the Green Bay Packers and Microsoft had partnered to launch a venture arm, TitletownTech.

Oculogica CEO Rosina Samadani spoke to a group of Green Bay area business and community leaders at TitletownTech in October.

"It was unbelievable that of all the teams in the NFL, someone in New York called me and asked if I knew about the Packers," Rosina Samadani said. "We could have ended up anywhere. And I didn't hear about it from someone in Wisconsin."

The connection to TitletownTech came through Jamie Wall, who worked at McKinsey when Rosina did and knew Craig Dickman, one of TitletownTech's managing directors

Jill Enos, the other managing director at TitletownTech and a member of Oculogica's board of directors, said the Samadani sisters' business made an instant impression on the TitletownTech team. 

"I was blown away by Rosina and Uzma, both their capabilities and deep expertise in the business," Enos said. "I was absolutely excited to find two female co-founders working on something so impactful in the digital health space. They're both tremendous individuals who are very accomplished and have big aspirations to accomplish more."

She said the $8 million raised through the partnership with TitletownTech will help the Samadanis produce and market EyeBOX devices for use by trauma centers and hospitals nationwide, develop engineering and manufacturing operations in Wisconsin, and dive further into the data the device collects to see if it can help assess conditions beyond concussions.

"We're very interested in getting the product out there, across the country, to sports medicine clinics and concussion clinics," Rosina Samadani said. "We're also working on a next-generation product, we're not sure what it'll be called yet, that will be a little smaller, a little more portable." 

The support and financing was exactly why the Packers and Microsoft established TitletownTech in 2018 and contributed $5 million each to the new venture fund. 

The organization is tasked with supporting new companies solving big problems in five industries: sports and entertainment, digital health, supply chain technology, agriculture and the environment, and advanced manufacturing.

In the two years since, TitletownTech has attracted financial support from the owners of the New York Mets and Boston Bruins and 12 Wisconsin-based companies. In total, the effort has raised at least $25 million for investment in startup companies. 

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Enos said Oculogica was the perfect fit, not just for its current mission, but also for its future potential.

"The other thing we're as excited about as the concussion piece is the data potential in the platform," Enos said. "They're gathering so many data tracking points by monitoring eye movement that it's about much more than concussion, but about brain health in general. The potential is still to be discovered."

Policy, the Packers general counsel, said Oculogica also committed to maintaining a presence in Wisconsin. 

"It meant a lot to us that they had their manufacturing and engineering operations in New Richmond (in their funding pitch)," he said. 

Rosina Samadani said TitletownTech has already provided an enormous amount of support and vital connections to health care providers and technology firms as the EyeBOX hits the market. 

"The money is one thing, but they have also connected us with Microsoft and we've talked with at least three different people at Microsoft about very specific needs," she said. "And we've also gotten exposure to the leadership of the Packers. That's a very big deal. They've connected us with health care facilities in the Green Bay region. They're serious about it."