Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2026
Using a hand-held pupillometer to quantify pupil constriction as part of the accommodation reflex.
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Olson DaiWai M, Perera Anjali, Kamal Abdulkadir, Jamili Maribel, Salter Amber, Mehari Haben, Bashir Moez M I
Аннотация
BACKGROUND: Quantitative pupillometry (QP) provides a reliable measure of the pupillary light reflex. The pupil accommodation reflex (P-AR) occurs when there is a change in visual focus from near to far or from far to near. The ability to measure the P-AR using handheld QP has not been described. We aimed to explore whether QP can objectively detect changes in pupil diameter associated with differences in gaze fixation distance.
METHODS: This prospective study enrolled 100 healthy adult volunteers. Bilateral QP measurements were obtained with each observation lasting 16 s (s) for both near and far focused gazes. Time-series plots were generated from the spreadsheet-based measurements, using the series of readings from each eye, and were subsequently uploaded for use in multiple data-analysis models.
RESULTS: From 200 paired bilateral observations, 178 provided reliable pupil measurements that differed during the far-focus, near-focus, far focus observation. Pupil diameter decreased significantly from far to near fixation (t = 11.52; P < 0.0001) and increased significantly when returning to far fixation (t = -9.73; P < 0.0001). Across all 200 observations, minimum and maximum pupil diameters differed significantly, confirming the presence of the miosis occurring as a component of the near triad response to gaze fixation. No significant difference was observed between eyes.
CONCLUSION: These novel findings establish QP as an objective method for quantifying the P-AR. This provides a potential tool for evaluating autonomic function, brain arousal, and neurophysiological integrity.
METHODS: This prospective study enrolled 100 healthy adult volunteers. Bilateral QP measurements were obtained with each observation lasting 16 s (s) for both near and far focused gazes. Time-series plots were generated from the spreadsheet-based measurements, using the series of readings from each eye, and were subsequently uploaded for use in multiple data-analysis models.
RESULTS: From 200 paired bilateral observations, 178 provided reliable pupil measurements that differed during the far-focus, near-focus, far focus observation. Pupil diameter decreased significantly from far to near fixation (t = 11.52; P < 0.0001) and increased significantly when returning to far fixation (t = -9.73; P < 0.0001). Across all 200 observations, minimum and maximum pupil diameters differed significantly, confirming the presence of the miosis occurring as a component of the near triad response to gaze fixation. No significant difference was observed between eyes.
CONCLUSION: These novel findings establish QP as an objective method for quantifying the P-AR. This provides a potential tool for evaluating autonomic function, brain arousal, and neurophysiological integrity.