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I recommend scrolling down to the "Try it out" section, click "Start", allow camera access, then you'll see a red dot appear on the screen.

You can then move your head... it works quite well! Scroll down to the "Archery Practice Area" to try it out

Does anything like this exist for Mac OS without npm as a requirement? With all the recent package compromises, I'm hesitant to use anything that requires NPM.
It's built in to MacOS.

Settings > Accessibility > Pointer Control > Alternate Control Methods > Head pointer