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pupillary dilatation reflex

Charlotte A Hall, Robert P Chilcott
The pupillary light reflex (PLR) describes the constriction and subsequent dilation of the pupil in response to light as a result of the antagonistic actions of the iris sphincter and dilator muscles. Since these muscles are innervated by the parasympathetic and sympathetic nervous systems, respectively, different parameters of the PLR can be used as indicators for either sympathetic or parasympathetic modulation. Thus, the PLR provides an important metric of autonomic nervous system function that has been exploited for a wide range of clinical applications...
March 13, 2018: Diagnostics
Andreas Brocher, Raphael Harbecke, Tim Graf, Daniel Memmert, Stefanie Hüttermann
We tested the link between pupil size and the task effort involved in covert shifts of visual attention. The goal of this study was to establish pupil size as a marker of attentional shifting in the absence of luminance manipulations. In three experiments, participants evaluated two stimuli that were presented peripherally, appearing equidistant from and on opposite sides of eye fixation. The angle between eye fixation and the peripherally presented target stimuli varied from 12.5° to 42.5°. The evaluation of more distant stimuli led to poorer performance than did the evaluation of more proximal stimuli throughout our study, confirming that the former required more effort than the latter...
March 7, 2018: Behavior Research Methods
Bharat Paliwal, Pradeep Bhatia, Narender Kaloria, Komal Chopra
No abstract text is available yet for this article.
February 23, 2018: Anesthesia and Analgesia
Chia-Lung Kao, I-Lin Hsu
PURPOSE: Suicide becomes a serious problem in today's society and hanging is a common method of suicide. We want to find the factors which can predict the final functional outcomes of these cases. METHODS: All patients who presented to Accident and Emergency Department (ED) of the National Cheng Kung University Hospital from 1st January 2005 to 31th December 2013 with a hanging injury were included in this study. All cases were divided into good outcome group and bad outcome group according to Glasgow Outcome Scale (GOS)...
January 31, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Rashmi Kumari, Bhawesh Chandra Saha
Persistent Hyperplastic Primary Vitreous (PHPV), now-a-days referred to as Persistent Fetal Vasculature (PFV), is a rare congenital anomaly of the eye that typically presents unilaterally with white pupillary reflex and microphthalmia without systemic associations. Bilateral presentations are rare. Here we report a case of 15-year-old male with bilateral PFV without leucokoria who was misdiagnosed as congenital esotropia with amblyopia, treated for refractive errors and referred to higher centre for squint corrections...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
Yung Ju Yoo, Jeong-Min Hwang, Hee Kyung Yang
OBJECTIVES: To determine the differences in pupillary light reflex (PLR) between the acute and chronic phases of optic neuritis (ON) and nonarteritic anterior ischemic optic neuropathy (NAION). METHODS: The study included 30 patients with ON and 22 patients with NAION whose PLR were measured by a dynamic pupillometer (PLR-200; NeurOptics Inc., Irvine, USA). Age-matched controls included 58 healthy individuals with normal vision and optic nerve function. Pupil diameters, latency, constriction ratio, constriction velocity and dilation velocity were noted...
2017: PloS One
Nada Sabourdin, Thomas Giral, Risa Wolk, Nicolas Louvet, Isabelle Constant
Pupillometry is a non-invasive monitoring technique, which allows dynamic pupillary diameter measurement by an infrared camera. Pupillary diameter increases in response to nociceptive stimuli. In patients anesthetized with propofol or volatile agents, the magnitude of this pupillary dilation is related to the intensity of the stimulus. Pupillary response to nociceptive stimuli has never been studied under ketamine anesthesia. Our objective was to describe pupillary reflex dilation after calibrated tetanic stimulations in patients receiving intravenous ketamine...
October 17, 2017: Journal of Clinical Monitoring and Computing
Alkinoos Athanasiou, Ioannis Balogiannis, Ioannis Magras
BACKGROUND: Lasting bilateral mydriasis and absence of pupillary light reflex following severe traumatic brain injury (TBI) are considered signs of irreversible brainstem damage and have been strongly associated with poor outcome. CASE DESCRIPTION: A young female patient presented with severe TBI, contusions, and diffuse brain edema. She was initially treated medically, but developed delayed secondary refractory intracranial hypertension and bilaterally dilated, non-reactive pupils for 12 h...
2017: Surgical Neurology International
Kazuko Totsuka, Hitoshi Ishikawa, Kazutaka Kamiya, Nobuyuki Shoji, Kimiya Shimizu
PURPOSE: To assess the light reflex of the pupil after Implantable Collamer Lens (ICL) (KS-aquaPORT; STAAR Surgical, Nidau, Switzerland) implantation to determine whether the ICL implantation might affect the pupil dynamics. METHODS: This study examined 28 eyes of 28 consecutive patients who underwent implantation of the posterior phakic ICL for the correction of myopia and astigmatism. Patient age at the time of surgery was 31.1 ± 6.8 years (range: 25 to 42 years)...
October 1, 2017: Journal of Refractive Surgery
Sérgio Vide, Catarina M Costa, Pedro L Gambus, Pedro P Amorim
Ketamine is an important component of multimodal treatment and a commonly used anesthetic drug. However, its analgesic effects have not been fully assessed intraoperatively because of difficulties in measuring this effect. In this case report, a woman underwent general anesthesia with ketamine and its pupillary reflexes were measured to detect autonomic changes in response to pain. With increasing doses of ketamine, the pupillary light reflex and the pupillary dilation response decreased. This could be caused by N-methyl-D-aspartate receptor antagonism in the pupillary reflexes pathway or by the analgesic effects of ketamine...
September 26, 2017: A & A Case Reports
Ahmed Al-Imam
An eighteen-year-old female patient of the Caucasian ethnicity from Australasia presented with a persistently dilated pupil causing her discomfort and occasional burning sensation when she is outdoors due to oversensitivity to sunlight. However, her pupillary reaction to light (pupillary light reflex) was intact. The patient is a known user of psychedelic substances (entheogens) including LSD, NBOMe, psilocybin, and DMT. The condition affects both eyes to the same extent. Thorough medical, neurological, and radiological examinations, including an EEG and an MRI of the head and neck region, were completely normal...
2017: Case Reports in Neurological Medicine
Philipp Moog, O Eren, S Kossegg, K Valda, A Straube, M Grünke, H Schulze-Koops, M Witt
OBJECTIVE: To assess autonomic function by infrared dynamic pupillometry in patients with ANCA-vasculitis (AAV) in correlation to autonomic symptoms, disease specific clinical parameters and cardiovascular reflex tests. METHODS: Patients with AAV and healthy controls underwent pupillometry at rest and after sympathetic stimulation (cold pressor test). Three parasympathetic parameters (amplitude, relative amplitude, maximum constriction velocity) and one sympathetic parameter (late dilatation velocity) were assessed...
December 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
Gilles C Martin, Pierre-Antoine Aymard, Charlotte Denier, Caroline Seghir, Marc Abitbol, Nathalie Boddaert, Dominique Bremond-Gignac, Matthieu P Robert
INTRODUCTION: Whereas apraclonidine has eclipsed cocaine test in the exploration of unilateral miosis in adults, its use in infants is avoided because of the risk of central nervous system depression. This chart review evaluates the usefulness of cocaine drops in infants. METHODS: Infants under the age of one referred for unilateral miosis between November 1, 2009 and November 1, 2015, were reviewed. Patients underwent the following protocol: (1) in case of isolated miosis, cocaine test was performed...
November 2017: European Journal of Paediatric Neurology: EJPN
Florian Roquet, Laila Guezouli, Bozena Wachowska, Iulia Balcan, Philippe Montravers, Dan Longrois, Jean Guglielminotti
No abstract text is available yet for this article.
December 2017: Anaesthesia, Critical Care & Pain Medicine
Shakoor Ba-Ali, Henrik Lund-Andersen
In recent years, chromatic pupillometry is used in humans to evaluate the activity of melanopsin expressing intrinsic photosensitive retinal ganglion cells (ipRGCs). Blue light is used to stimulate the ipRGCs and red light activates the rod/cone photoreceptors. The late re-dilation phase of pupillary light reflex is primarily driven by the ipRGCs. Optic neuropathies i.e. Leber hereditary optic neuropathy (LHON), autosomal dominant optic atrophy (ADOA), nonarteritic anterior ischemic optic neuropathy (NAION), glaucoma, optic neuritis and idiopathic intracranial hypertension (IIH) are among the diseases, which have been subject to pupillometric studies...
July 14, 2017: Mitochondrion
Yung Ju Yoo, Hee Kyung Yang, Jeong-Min Hwang
OBJECTIVES: To evaluate the efficacy of digital pupillometry in the diagnosis of anisocoria related to Horner syndrome in adult patients. DESIGN: Retrospective, observational, case control study. METHODS: Nineteen patients with unilateral Horner syndrome (Horner group) and age-matched controls of 30 healthy individuals with normal vision and neither optic nerve dysfunction nor pupillary abnormalities were included. Pupillary light reflex (PLR) of the Horner group and controls were measured by a dynamic pupillometer (PLR-200; NeurOptics Inc...
2017: PloS One
Baptiste Duceau, Mélanie Baubillier, Gaëlle Bouroche, Aline Albi-Feldzer, Christian Jayr
BACKGROUND: Although thoracic paravertebral block (TPVB) is recommended in major breast surgery, there is no gold standard to assess the success of TPVB. Pupillary dilation reflex (PDR) is the variation of the pupillary diameter after a noxious stimulus. The objective was to evaluate the feasibility of recording the PDR to assess analgesia in an anesthetized thoracic dermatome after TPVB. METHODS: This prospective, observational, single-center study included 32 patients requiring breast surgery under general anesthesia and TPVB...
October 2017: Anesthesia and Analgesia
Rudrashish Haldar, Prakhar Gyanesh, Arun Srivastava, Guru Prasad Bettaswamy
The superior orbital fissure syndrome (SOFS) is a rare condition presenting as painful unilateral opthalmoplegia, ptosis, pupillary dilatation and anesthesia of the upper eyelid and forehead. It has been described after facial trauma. Other etiologies include infections, tumors or spontaneous hemorrhages in the retro-orbital space. Occurrence of SOFS after surgery in the skull base has not been described before. We recently encountered a case where a young female developed SOFS following surgery for cerebrospinal fluid (CSF) rhinorrhea...
January 2017: Asian Journal of Neurosurgery
Melissa M Cortez, Natalie A Rea, Lindsay A Hunter, Kathleen B Digre, K C Brennan
Background Autonomic dysfunction and light sensitivity are core features of the migraine attack. Growing evidence also suggests changes in these parameters between attacks. Though sensory and autonomic responses likely interact, they have not been studied together across the spectrum of disease in migraine. Methods We performed digital infrared pupillometry while collecting interictal photophobia thresholds (PPT) in 36 migraineurs (14 episodic; 12 chronic; 10 probable) and 24 age and sex-matched non-headache controls...
July 2017: Cephalalgia: An International Journal of Headache
Arpine Barsegian, Adam Botwinick, Harsha S Reddy
PURPOSE: To characterize the phenylephrine test in ptotic patients to help clinicians perform the test more efficiently. METHODS: Adults with involutional ptosis (n = 24, 30 eyes) were assessed with digital photographs for response to topical 2.5% phenylephrine drop instillation. Patient characteristics (age, gender, iris color, dermatochalasis, brow ptosis, and baseline marginal reflex distance-1 [MRD-1] height) were recorded. From the photographs, change in (MRD-1), presence of conjunctival blanching, pupillary dilation, and Hering effect were recorded at specified time intervals, 1 minute to 1 hour after drop placement...
March 28, 2017: Ophthalmic Plastic and Reconstructive Surgery
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