Patients with amyotrophic lateral sclerosis (ALS) require an external communication device. The system takes on different characteristics depending on the stage of the disease. This research provides a vision-based communication system for end-stage patients who can communicate with their eyes. Hardware and software were used to create the communication system. A headset with a wearable glass, sensitive camera, and near-infrared light was used to implement eye-tracking technology. The commands were displayed on a computer screen. The software for the system was created with the eye-tracking and calibration process in consideration. Furthermore, smart software for the user interface was created, which included six critical needs to be reported. The system has been tested and has yielded convenient results. In this way, patients with ALS can have a dependable, safe, non-invasive, and low-cost communication device to help them with their daily activities.