Pupillary Light Response, Pupillary Response

2012 ◽  
Keyword(s):  
Light Response ◽  
Pupillary Response ◽  
Pupillary Light

scholarly journals Evaluation of Disk Halo Size after Implantation of a Collamer Lens with a Central Hole (ICL V4c)

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Xun Chen ◽  
Tian Han ◽  
Feng Zhao ◽  
Huamao Miao ◽  
Xiaoying Wang ◽  
...  
Keyword(s):  
Light Response ◽  
Pupillary Response ◽  
Central Hole ◽  
Implantable Collamer Lens ◽  
Contraction Amplitude ◽  
Pupillary Light ◽  
Significant Difference ◽  
Icl V4c ◽  
Latency Duration ◽  
Average Pupil

Purpose. To investigate disk halo size changes produced by a glare source after surgical insertion of an implantable collamer lens with a central hole (ICL V4c) for myopia correction. Methods. In this prospective study, disk halo size and pupillary light response with a vision monitor were measured preoperatively and at 1 week, 1 month, and 3 months postoperatively. Pupillary light response parameters included contraction amplitude, latency, duration, and velocity; dilation latency, duration, and velocity; and initial, maximum, minimum, and average pupil diameters. Results. Forty-two right eyes of 42 patients were enrolled. Postoperative uncorrected distance visual acuity was better than or equal to 20/20 in all eyes. Compared to preoperative values, disk halo size showed no significant difference at 1 week postoperatively (P>0.05) and then decreased significantly at 1 and 3 months postoperatively (both P<0.001). Contraction amplitude and velocity, as well as dilation velocity, decreased significantly at all postoperative time points (all P<0.001). Disk halo size at 3 months postoperatively was significantly correlated with initial (r = 0.446, P=0.003), maximum (r = 0.483, P=0.001), minimum (r = 0.425, P=0.005), and average pupil diameters (r = 0.474, P=0.002). Conclusions. After ICL V4c implantation, disk halo size was reduced in the short term. Patients with smaller pupil sizes during pupillary response to light experienced smaller halos after ICL V4c implantation.

scholarly journals Pupillary Response to Light is Preserved in Patients without Brain Insult Undergoing Rapid Sequence Intubation

2020 ◽  
pp. 129-136
Author(s):  
Abhishek Chaturbedi ◽  
Jitendra Thakur ◽  
Aashik Jha ◽  
Milan Niraula
Keyword(s):  
Neuromuscular Blockade ◽  
Reference Group ◽  
Light Response ◽  
Pupillary Response ◽  
Rapid Sequence Intubation ◽  
Case Group ◽  
Reflex Mechanism ◽  
Pupillary Light ◽  
Rapid Sequence ◽  
Number Of Patients

Objective of the Study: This paper has been aimed to determine whether the pharmacological neuromuscular blockade with rocuronium during emergency Rapid Sequence Intubation (RSI) affected pupillary response to light (PLR) in patients with brain insult as compared to patients who had non- neurological illness. Previous studies elucidated that RSI with pharmacological neuromuscular blockade does not affect PLR, except in patients with significant neurological lesion. Our objective is to examine the validity of existing but scarce literature on this subject, with further stratification of patients involved in this study into neurological and non-neurological disease groups. Methods: This was a prospective case-reference study of case group with brain insult patients compared with reference group of patients without neurological diseases undergoing RSI in emergency settings. It is single centered study, conducted from October 2019 till May 2020. A pair of a neurosurgeon and a medical officer assessed pupillary light response after administration of neuromuscular blockade and intubation, each blinded to other’s assessment of PLR. Cases without pupillary response before RSI intubation were excluded. The primary outcome measure was clinically observable Pupillary Light Response (PLR) following neuromuscular blockade with Rocuronium in each group. Results: We examined 50 patients undergoing RSI with Rocuronium, either in emergency department or Intensive Care Unit (ICU), 25 each in index and reference group respectively. All patients in the reference group showed PLR after RSI. Of case group patients receiving RSI, only15 of 25 (60%) demonstrated PLR after RSI. This was statistically significant (p value<0.05) when compared to number of patients with intact PLR after RSI in reference group. Cohen’s Kappa Coefficient (k) for inter-observer agreement was 0.70. Conclusion: Rocuronium does not appear to affect PLR after emergent RSI in patients without brain injury. Only in patients with known brain insult showed impaired PLR, suggesting impaired pupillary light reflex mechanism may be the culprit for this aberration, rather than pharmacological neuromuscular blockade.

The cat's pupillary light response under urethane anesthesia

1995 ◽  
Vol 12 (2) ◽  
pp. 281-284 ◽  
Author(s):  
J.K. Oh ◽  
D.L. Bohnsack ◽  
J.B. Troy ◽  
Ch. Enroth-Cugell
Keyword(s):  
Light Response ◽  
Pupillary Response ◽  
Retinal Illuminance ◽  
Urethane Anesthesia ◽  
Pupillary Light

AbstractPupillary area was measured in urethane-anesthetized cats as a function of retinal illuminance. When appropriate corrections are made for differences in experimental procedures, it was found that the pupillary response of the urethane-anesthetized cat's eyes to light was basically unchanged from that of the alert behaving cat. This preparation may therefore be a very satisfactory one in which to study the pupillary response pathway in a higher mammal.

The pupillary light response reflects encoding, but not maintenance, in visual working memory.

2016 ◽  
Vol 42 (11) ◽  
pp. 1716-1723 ◽  
Author(s):  
Tessel Blom ◽  
Sebastiaan Mathôt ◽  
Christian N. L. Olivers ◽  
Stefan Van der Stigchel
Keyword(s):  
Working Memory ◽  
Visual Working Memory ◽  
Light Response ◽  
Pupillary Light

Abstract 16483: Prognostic Value of Neurological Exam in Cardiac Arrest Patients Treated With Therapeutic Hypothermia in the Absence of Withdrawal of Life-sustaining Therapy

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Elizabeth Matthews ◽  
Jessica Magid-Bernstein ◽  
Angela Velazquez ◽  
Cristina Falo ◽  
Soojin Park ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Therapeutic Hypothermia ◽  
Cause Of Death ◽  
Prognostic Value ◽  
Light Response ◽  
Pupillary Response ◽  
Columbia University ◽  
Poor Outcome ◽  
Corneal Reflex ◽  
Neurological Exam

Objectives: Withdrawal of life-sustaining therapy (WLST) is the most common cause of death following cardiac arrest (CA). A well-described “self-fulfilling prophecy” exists, in which a poor exam often prompts WLST. The prognostic value of the neurological exam at various time points, in the absence of WLST, remains unknown. Methods: All patients (N=291) treated at Columbia University with therapeutic hypothermia (TH) following CA between May 2007 and February 2015 were identified. Neurological exams were documented at admission, 72 hours, five days and seven days after arrest. Glasgow coma motor scores (GCS-motor) no better than extensor posturing, bilaterally absent pupillary light response and bilaterally absent corneal reflexes were considered poor exams. Patients were excluded if the cause of death was WLST (n=125) or they died despite full support prior to 7 days (n=70). A cerebral performance score (CPC) at hospital discharge of 3-5 was considered a bad outcome. False positive rates (FPRs) in percentages were calculated. Results: A total of 96 patients were analyzed (average age 59±17 years, 40% female, 91% with pre-hospitalization CPC 1-2, bystander CPR in 69%, initial rhythm of VT/FT in 41%, mean ROSC 19±15 minutes). Sixty-one percent of patients had a poor outcome. GCS-motor was associated with a poor outcome, with FPRs of 36.3% (21-63.6), 29.4% (15.7-47.7), 11.8% (3.8-28.4) and 10.8% (3.5-26.4) at admission, 72 hours, five days and seven days respectively. Bilaterally absent corneal reflexes had FPRs of 29.2% (13.4-51.3), 26.3% (10.1-51.4), 5.3% (0.3-28.1) and 0% (0-18.5). Bilaterally absent pupillary response had the lowest FPRs at 8.3% (2.2-23.6), 0% (0-13.3), 0% (0-14.1), and 0% (0-13.7). Conclusion: A poor neurological exam remains a significant predictor of poor outcome following cardiac arrest. In the setting of TH, the pupillary exam reaches 100% specificity at 72 hours, while the GCS-motor and corneal reflex have unacceptably high rates of good outcomes despite poor exams. They become more specific over time, suggesting that patients may benefit from delaying prognostication until at least five days after arrest.

scholarly journals Quantitative Pupillometry in the Intensive Care Unit

2019 ◽  
pp. 088506661988112
Author(s):  
Matthew M. Bower ◽  
Alexander J. Sweidan ◽  
Jordan C. Xu ◽  
Sara Stern-Nezer ◽  
Wengui Yu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Objective Assessment ◽  
Light Response ◽  
Pressure Monitoring ◽  
Neurological Intensive Care Unit ◽  
Neurological Intensive Care ◽  
Pupillary Light ◽  
Pupillary Reactivity ◽  
Neurological Pupil Index

Quantitative pupillometry provides a noninvasive and objective assessment within the neurological examination. This review details the physiology of the pupillary light response, the clinical significance of changes in pupillary reactivity, and the variables that compose the Neurological Pupil index or NPi are discussed. This article reviews the most recent applications and advances in quantitative pupillometry for noninvasive intracranial pressure monitoring, postcardiac arrest prognostication, and subarachnoid hemorrhage. Also discussed are the limitations and confounders of quantitative pupillometry in the modern neurological intensive care unit.

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