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At least 703 records · Page 39Linked to original sources
PubMed1985

Pupil size in relation to ultrasonic anterior chamber depth measurements in pseudophakic eyes.

The effect of pupil size on ultrasonically determined anterior-chamber depth was studied in vitro with the Storz Alpha 20/20 and with the Kretz ultrasonoscope at high and low system sensitivity. The traces were measured peak to peak and base to base; results were compared to anterior-chamber depth measurements with optical pachymetry. We conclude that when measuring anterior-chamber depth with ultrasound, the pupil must be fully dilated or reduced system sensitivity must be used and the traces measured peak to peak.

Aged↗
PubMed1994

The pupil photostress test.

PURPOSE: An objective, pupillographic photostress test was developed to assess the initial sensitivity loss and its rate of recovery in healthy eyes and in eyes affected by optic neuropathy. METHODS: Pupillary light reflexes were recorded with an infrared pupillometer after a binocular photostress that subtended 30 degrees of the central visual field. The initial loss of light sensitivity (in log units) and its recovery with time were derived by analyzing subsequent increases in pupil contraction amplitude to a series of alternating light stimuli. The effects of photostress duration and intensity were studied in ten control subjects. Photostress recovery also was compared between eyes of nine patients with unilateral optic neuropathy. RESULTS: In the ten control subjects, increasing photostress duration caused significantly increased sensitivity loss at time zero after the photostress (analysis of variance), but did not significantly affect the exponential recovery rate. Intense photostress brightness caused more initial sensitivity loss than did dimmer photostress lights. In addition, half-time of sensitivity recovery was prolonged after the brightest photostress. In nine patients with unilateral optic neuropathy, a 120-second photostress caused significantly less initial sensitivity loss in the affected eye than in the healthy fellow eye. CONCLUSIONS: The pupil photostress test objectively can measure the eye's loss of light sensitivity after a photostress and its exponential rate of recovery. Loss of optic nerve function diminishes the initial stress-induced loss of light sensitivity and does not significantly affect the poststress rate of recovery in the patients tested.

Adult↗
PubMed1991

Systemic atropine administration during cardiac arrest does not cause fixed and dilated pupils.

OBJECTIVES: Systemic administration of atropine during CPR may postpone brain death determination because of its reputed ability to produce fixed and dilated pupils. We studied the effect of atropine administered in the usual doses as an adjunct to endotracheal intubation and for cardiac arrest to determine if it would interfere with neurological assessment. DESIGN: Two groups of children were studied. Group 1 consisted of 28 patients who received atropine (0.03 +/- 0.003 mg/kg) prior to endotracheal intubation. Group 2 consisted of 21 patients previously without evidence of brainstem disease who suffered a witnessed arrest and had prompt return of spontaneous circulation and received an atropine dose of 0.03 +/- 0.01 mg/kg. RESULTS: In group 1, pupillary size averaged 4.02 +/- 0.78 mm before and 4.75 mm +/- .84 mm after atropine (P less than .001). In group 2, the pupillary examination was conducted 30 minutes after return of spontaneous circulation. The pupillary diameter was 4.80 +/- 0.91 mm. All pupils were reactive to light in both groups. CONCLUSION: Atropine administration in conventional dose causes slight pupillary dilation but does not abolish pupillary light reactivity.

Adolescent↗
PubMed1992

Relationship between postoperative pupil size and disability glare.

A group of 40 postoperative cataract patients had Miller-Nadler glare testing performed before and after midpupillary pharmacologic dilation. The results indicated that pupillary enlargement is associated with increased glare disability. For that reason it is essential to maintain normal pupil shape and function after cataract surgery, a difficult task in cases with miotic pupils.

Cataract Extraction↗
PubMed1992

Preplaced inferior iris suture method for small pupil phacoemulsification.

A surgical method for managing poorly dilating pupils preoperatively is presented. A fine polypropylene suture is preplaced through the inferior iris sphincter prior to an inferior radial iridotomy in preparation for nucleus fracture endolenticular phacoemulsification. Placing the suture prior to the iridotomy assures proper aesthetic and functional alignment of the incised iris pillars, while enlarging the pupil inferiorly accommodates in-the-bag nucleus emulsification. This new surgical method maintains pupillary appearance and function postoperatively.

Cataract Extraction↗
PubMed1992

Small pupil enlargement during cataract extraction. A new method.

A new method for enlarging a small pupil during cataract extraction is described. The technique is simple and safe, and uses new instruments that reduce or entirely eliminate the need to incise or suture the iris. This method of pupil enlargement can be used for extracapsular cataract extraction and phacoemulsification procedures.

Cataract Extraction↗
PubMed1993

Enlarging the pupil for cataract extraction using flexible nylon iris retractors.

A technique using flexible iris retractors to manage small pupils during cataract extraction reduces iris trauma, allows adjustment of pupil size, and reduces intraoperative difficulty more than previously described techniques. This method is appropriate for extracapsular cataract extraction and phacoemulsification, as well as the posterior segment procedures for which it was originally described.

Cataract Extraction↗
PubMed1993

Centration of excimer laser photorefractive keratectomy relative to the pupil.

The centration of excimer laser photorefractive keratectomy (PRK) is critical to the procedure's success. We evaluated PRK centration in 49 patients using the EyeSys topography system. Ablation zone centration was measured from the corneal vertex and from the pupillary center using the pupil-finding software. Centration was measured more accurately from the pupillary center (0.40 mm) than from the corneal vertex (0.44 mm). Right eyes were decentered less than left eyes. There was an unpredictable correlation between amount of decentration and postoperative visual acuities. The ability to measure centration of keratorefractive procedures precisely from the pupil is an important advance in topography technology.

Cornea↗
PubMed1993

Phacoemulsification with poorly dilated pupils.

Tilting the viewing angle of the operating microscope during phacoemulsification provides the surgeon a better view of the cataractous lens. This technique, combined with continuous curvilinear capsulorhexis, divide and conquer nucleofractis, and lens rotation in the capsular bag, allows the surgeon to perform most of the phacoemulsification procedure near a well-visualized 6 o'clock meridian. This procedure can eliminate the need for iris surgery in cases with small pupils. Also discussed is the removal of the upper half of the cortical substance in patients with small pupils.

Cataract Extraction↗
PubMed1996

Avoiding complications associated with iris retractor use in small pupil cataract extraction.

While there are several options for managing the small pupil during cataract surgery, adjustable iris retractors are beneficial when there is a risk of cutting or tearing the iris, such as with rubeosis. Appropriate use of this new surgical tool includes proper placement of the parcenteses and a gradual and limited enlargement of the pupil, perhaps to no more than 5.0 mm.

Cataract Extraction↗
PubMed2000

Effect of irrigating solution and irrigation temperature on the cornea and pupil during phacoemulsification.

PURPOSE: To evaluate the effect of irrigation solution and temperature on pupil diameter, corneal endothelium, and corneal pachymetry during and after phacoemulsification. SETTING: Klinik Dardenne, Bonn, Germany. METHODS: Eighty patients who had cataract surgery by phacoemulsification were assigned to 1 of 4 cross-classified groups and had intraoperative irrigation with room-temperature or refrigerated fortified balanced salt solution (BSS Plus) or modified Ringer's solution. Pupil diameters were recorded at different stages during the surgery. Epithelial cell counts and pachymetry were determined before and 1 day after surgery. RESULTS: The solution temperature did not affect any parameter. The type of solution did not influence endothelial cell loss; however, the solution had a significant effect on corneal pachymetry 1 day postoperatively. The corneas irrigated with BSS Plus were less swollen than the corneas irrigated with Ringer's solution. By day 14, corneal thickness was equal among all groups. CONCLUSION: Long-term results were equally favorable in all 4 groups. However BSS Plus induced less short-term corneal swelling than Ringer's solution. From these findings, it appears that BSS Plus may decrease corneal risk in cases with compromised corneas or prolonged surgery.

Adult↗
PubMed1977

A non-permanent tonic pupil in rheumatoid arteritis.

A 76-year-old male with a severely deforming rheumatoid arthritis, eosinophilia, polymyositis, and episcleritis developed a transient tonic pupil. The episcleritis, and a muscle biopsy revealing an occlusive arteritis with eosinophilia, suggest that a wide-spread rheumatoid arteritis caused a reversible ischemic insult to the ciliary ganglion and thus created a transient denervation of the pupil.

Aged↗
PubMed1999

Pituitary apoplexy after cardiac surgery presenting as deep coma with dilated pupils.

Acute clinical deterioration due to infarction or haemorrhage of an existing, often previously unrecognized, pituitary tumour is a rare but well-described complication. It can occur spontaneously or may be caused e.g. by mechanical ventilation, infection or surgical procedures. We report on a case of pituitary apoplexy occurring in a 64-year-old patient 3 weeks after cardiac surgery. The patient presented with deep coma and dilated pupils. Magnetic resonance imaging revealed a haemorrhagic pituitary tumour. After prompt endocrinologic replacement therapy with levothyroxine and hydrocortisone the patient regained consciousness. Neurological examination revealed right oculomotor nerve palsy and bilateral cranial nerve VI palsy. Subsequent trans-sphenoidal removal of a nonfunctional macroadenoma with large necrotic areas was performed. The patient recovered completely. To our knowledge, pituitary tumours presenting with a combination of deep coma and dilated pupils must be considered exceedingly rare. Possible pathophysiologic mechanisms are discussed. As our case illustrates, even in severe cases complete recovery is possible if the diagnosis is suspected, and diagnostic and therapeutic measures are initiated in time.

Coma↗
PubMed1989

Pupil dilatation with tropicamide. The effects on acuity, accommodation and refraction.

The effect of pupil dilatation with tropicamide 1% on visual acuity and accommodation was assessed in 100 eyes of 52 consecutive patients attending the general ophthalmic outpatient clinic. Snellen visual acuity remained unchanged in 55 eyes and deteriorated by one line in 41 eyes. The remaining four eyes deteriorated by two lines. Tropicamide gave rise to a reduction in the amplitude of accommodation which tended to vary inversely with the age of the patient. However, all patients who wore reading glasses for presbyopia were still able to read when their pupils had been dilated.

Accommodation, Ocular↗
PubMed2002

Dilated pupils and loss of accommodation following diode panretinal photocoagulation with sub-tenon local anaesthetic in four cases.

AIM: To describe pupillary abnormalities associated with diode laser photocoagulation with subTenon's local anaesthetic. METHODS: We describe four cases of tonic pupils following diabetic panretinal photocoagulation with subTenon's local anaesthetic. RESULTS: Six pupils of four patients became dilated and sustained loss of accommodation with denervation hypersensitivity with 0.1% pilocarpine after undergoing panretinal photocoagulation with a subTenon's local anaesthetic. The numbers of burns were not excessive and in one patient it even occurred after only 1200 laser burns. CONCLUSION: Diode laser causes histological changes deeper in the retina and the choroid than in Argon laser. Intense diode laser burns may cause damage to the short ciliary nerves traversing the choroid. In the unanaesthetised patient, pain arises when the laser burn hits these nerves and so may protect the eye from excess damage to the nerves. When the eye is anaesthetised with a subTenon's, local anaesthetic damage to the choroidal nerves may occur without the laser operator being aware that the burns are too intense.

Adult↗
PubMed2003

Pupil size and reaction during functional endoscopic sinus surgery (FESS).

This aim of this study was to evaluate the size and light reflex of the pupils during endoscopic sinus surgery (FESS). Pupil size and light reflexes were recorded prospectively in 20 patients undergoing FESS under general anaesthesia. Nasal mucosal vasoconstriction was induced by Moffett's solution. A control group of 20 patients underwent other standard ENT operations under general anaesthesia. Myosis occurred in all 40 patients after induction of general anaesthesia. During surgery, the light reflex was negative for all 40 patients. However, the light reflex became positive in 22 patients within 5 min of surgery, and in all patients after 20 min. Monitoring pupillary size and reflexes during FESS as a means of assessing trauma to the orbital structures is difficult because of the presence of myosis induced by anaesthetic agents. Moffett's solution did not have a mydriatic effect from the systemic absorption of cocaine during the operative period.

Adolescent↗
PubMed2006

Pupil response to color signals in cone-contrast space.

PURPOSE: It is widely accepted that pupil responses to visual stimuli are determined by the ambient illuminance, and recently it has been shown that changes in stimulus color also contributes to a pupillary control mechanism. However, the role of pupillary responses to chromatic stimuli is not clear. The aim of this study was to investigate how color and luminance signals contribute to the pupillary control mechanism. METHODS: We measured pupillary iso-response contours in M-and L-cone contrast space. The iso-response contours in cone-contrast space have been determined to examine what mechanisms contribute to the pupillary pathway. The shapes of the iso-response contour change when different mechanisms determine the response. RESULTS: It was shown that for all subjects, the pupillary iso-response contours form an ellipse with positive slope in cone-contrast space, indicating that the sensitivities to the chromatic stimuli are higher than those for the luminance stimuli. The pupil responds maximally to a grating that has a stronger L-cone modulation than the red-green isoluminant grating. CONCLUSIONS: The sensitivity of the chromatic pathway, in terms of pupillary response, is three times larger than that of the luminance pathway, a property that might have utility in clinical applications.

Color Perception↗
PubMed2001

Effects of 2% ibopamine on pupil, refraction, anterior segment anatomy and intraocular pressure.

The aim of the study was to determine the effects of a dopaminergic drug, 2% ibopamine, on the pupil, intraocular pressure and other ocular and ultrasound biometric variables. Thirty healthy subjects and 15 patients with primary open-angle glaucoma, aged from 40 to 78 years (mean age: 59.2 +/- 11), were included in two prospective open controlled trials. In the first, the mydriatic effect of 2% ibopamine and its inhibition and reversibility were evaluated in 15 healthy subjects using the alpha1-adrenergic drug, 0.5% dapiprazole. In the second, refraction, visual acuity, pupil diameter, intraocular pressure and 5 A-scan ultrasound biometric variables were evaluated in 15 healthy subjects and in 15 glaucoma patients. As early as forty min after administration of 2% ibopamine, a marked mydriatic effect (7.3 vs 3.9 mm; P < 0.0001), which was completely inhibited or reversed by 0.5% dapiprazole, was detected. The drug induced no changes in refraction, visual acuity or A-scan ultrasound biometric variables in any of the subjects examined. In healthy subjects, the intraocular pressure values were not changed to a statistically significant extent (13.8 vs 14.8 mm Hg; P = 0.668), whereas a slight, though significant, hypertensive effect (24 vs 22.2 mm Hg; P = 0.002) was observed in the glaucoma patients. The study confirms the intense mydriatic effect of 2% ibopamine with no changes in refraction, visual acuity or A-scan ultrasound biometric variables. The drug has no effect on intraocular pressure in healthy subjects, but induces a significant hypertensive effect in patients with initial glaucoma. This characteristic could be used for early diagnosis of primary open-angle glaucoma.

Adrenergic alpha-Antagonists↗