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At least 757 records · Page 42Linked to original sources
PubMed1990

The abnormal pupil in Cheyne-Stokes respiration. Case report.

Cheyne-Stokes respiration commonly induces a rhythmic pupillary dilatation during hyperpnea and constriction during apnea. Failure of a pupil to dilate during hyperventilation indicates underlying sympathetic nerve paralysis. This report deals with an instance in which one pupil failed to constrict during apnea due to oculomotor nerve compression. The periodic respirations and anisocoria disappeared following surgical evacuation of a large ipsilateral subdural hematoma.

Anisocoria↗
PubMed1995

One-year outcome following craniotomy for traumatic hematoma in patients with fixed dilated pupils.

Forty consecutive patients who underwent craniotomy for traumatic hematoma after developing bilateral fixed dilated pupils were studied to determine the factors influencing quality of survival and to seek criteria for management. Clinical and computerized tomography (CT) data were correlated with outcome 1 year after craniotomy. The functional recovery (good outcome or moderate disability) rate was 25%, with a mortality rate of 43%. Patients with subdural hematoma had a higher mortality rate (64%) compared to patients with extradural hematoma (18%) (chi-square test, p > 0.05). Other factors associated with markedly increased morbidity and mortality were increasing age (> 20 years), a prolonged interval (> 3 hours) between loss of pupillary reactivity and craniotomy, compression of basal cisterns, and presence of subarachnoid hemorrhage on CT. There were no survivors among patients exhibiting any of the following features: surgery 6 hours or more after bilateral loss of pupillary reactivity; age greater than 65 years; or absent motor response. Apart from the latter group, the nature of motor response (before pharmacological paralysis and intubation) was not a reliable predictor of mortality. The results suggest that the presence of an acute subdural hematoma is the single most important predictor of negative outcome in patients with bilateral unresponsive pupils.

Adolescent↗
PubMed1999

[Leukocoria (white pupil) among children--mother is always right].

Leucocoria is a rare, but serious symptom in early childhood. It may be present at birth or develop during infancy. As in adults, infants usually display a black pupil, and upon shining a bright light into the pupil with the ophthalmoscope, an orange or red reflex emerges. The first person to see that something is wrong, is often the mother, but she cannot give a precise description. When the infant is crying it can be difficult to examine the red reflex, and the necessity of admitting the infant to an ophthalmologist, when the mother is worried, is discussed. In this paper we discuss two cases of retinoblastoma and one case of congenital cataract where the treatment was delayed due to late diagnosis of the leucocoria. The main conclusion is always to listen to the relatives when they are worried about the infant's eye, and to make sure that the infant is properly examined.

Adult↗
PubMed2002

Long term outcome in patients with severe head injury and bilateral fixed dilated pupils.

Patients with severe head injury with bilateral dilated unreactive pupils are considered to have a grave prognosis. Hence proper planning and aggressive management becomes mandatory for achieving good results. We present the outcome of consecutive 166 patients with severe head injury, admitted between January 1996 and December 2000 and analysed retrospectively. All the patients had an initial GCS of 8 or less and post resuscitation bilateral dilated unreactive pupils. Our aim was to analyze the long term outcome in these patients and identify the other significant prognostic factors. Of the 166 patients, 42 (25.30%) had a functional outcome (good recovery in 10.24%, moderate disability in 15.06%), and 124 (74.69%) had a poor outcome (death in 58.43% and severe disability in 16.26% of cases). There were 45 patients with polytrauma and 24 of these patients (53.33%) succumbed to the injuries. Obliteration of the basal cisterns and contusion were the common CT scan findings. Factors adversely affecting the survival included age of the patient, polytrauma with shock, initial GCS of 3 or 4, and compression of the basal cisterns on the initial CT scans. At follow up, most of the patients with a functional outcome showed a significant improvement in their motor function but continued to have neuro-behavioral and cognitive deficits.

Adolescent↗
PubMed1992

[Accommodative resting position and the effect of viewing distance on after-effects of accommodation and the pupil].

The resting position of accommodation is determined by the equilibrium established between sympathetic and parasympathetic tone. To accommodate for near objects is brought about by excitation of the parasympathetic, and distant objects call for excitation of the sympathetic system. To investigate accommodation and pupil after-effects following the 10 min visual task with stereoscopic three dimensional image, the measurements of the dynamic responses of accommodation and pupil were made. When the subjects worked at 0.4 m (closer than their resting state) and at 1 m corresponded to their resting positions, the response delay in accommodative relaxation occurred in each condition. When they worked at outside their resting position (1.5 m and 3 m viewing distances), the significant response delay in contraction in the groups of 1.5 m and 3 m, and the increases of accommodation error and the area of miosis were shown. There was a fact that the after-effect on accommodation and pupillary function was different between in the case of tasks given inside and outside their resting positions.

Accommodation, Ocular↗
PubMed1992

Effects of prostaglandin F2 alpha and leukotriene D4 on pupil size, intraocular pressure, and blood-aqueous barrier in dogs.

In each of 5 groups of dogs, 0.05 ml of 1 of the following solutions was injected into the anterior chamber of both eyes: phosphate-buffered saline solution, 0.001 microgram of prostaglandin F2 alpha (PGF2 alpha), 0.01 microgram of PGF2 alpha, 0.1 microgram of leukotriene D4 (LTD4), and 1 microgram of LTD4. A 10% solution of sodium fluorescein was injected IV (14 mg/kg of body weight) at the same time, and pupil size, intraocular pressure, and anterior chamber fluorescence were measured for 1 hour after injections. In a dose-dependent manner, PGF2 alpha was a potent miotic. A significant effect on intraocular pressure was not detected when the groups given PGF2 alpha were compared with the control group. When compared with LTD4, PGF2 alpha significantly (P less than 0.05) increased the breakdown of the blood-aqueous barrier, as evidenced by increased fluorescein leakage into the anterior chamber. Leukotriene D4 caused a decrease in pupil size only at 5 minutes, compared with that of the control group. Intraocular pressure was greater (but not significantly) in the group given 1 microgram of LTD4.

Animals↗
PubMed2006

[A case of autoimmune autonomic neuropathy with marked orthostatic hypotension, decreased salivation, constipation, and Adie pupil].

We report a 68-year-old man with subacute autonomic failure who developed orthostatic hypotension, decreased salivation, constipation, and Adie pupil. There was no evidence of central neurodegeneration, sensory and motor dysfunction. Head-up tilt test showed marked orthostatic hypotension without tachycardia. The patient had a low plasma noradrenaline concentration while supine and a poor noradrenaline response to head-up. Adie pupil responded to 0.125% pilocarpine, establishing denervation hypersensitivity of the parasympathetic nerve. Blood pressure, However, did not show a remarkable response to 0.05-0.2gamma noradrenaline, demonstrating the absence of denervation hypersensitivity of the sympathetic nerve. In contrast to patients with pure autonomic failure, the patient showed normal uptake of I-123-MIBG in the myocardium, indicating intact postganglionic sympathetic innervation. Serologic testing demonstrated circulating antibody to the ganglionic acetylcholine receptor (AchR). Because of subacute clinical course, autonomic symptoms and presence of anti-ganglionic AchR antibody, autoimmune autonomic neuropathy was diagnosed.

Aged↗
PubMed1990

[Effect of ultraviolet light on the hamster pupil].

This is the first study on the effects of ultraviolet light (UV) on the hamster pupil in vivo and in vitro. UV caused constriction of the pupil even after the death of the hamster. Both visible light and UV induced myosis of the enucleated hamster eyes. UV-induced miosis occurred very late and continued after the cessation of UV stimuli. The UV-induced miosis was not significantly affected by ascorbic acid, catalase, allopurinol, but it was gradually inhibited by procaine or quinacrine, phospholipase A2 inhibitors. Withdrawal of Ca2+ and Mg2+ with EGTA and/or EDTA strongly inhibited the UV-induced miosis. This study suggests that the UV-induced miosis was not related to oxidative stress, but related to a second messenger via the muscle cell membrane.

Animals↗
PubMedDate not supplied

The importance of pupil size in optical quality measurements following radial keratotomy.

This review considers the importance of pupil size when specifying the optical quality or visual performance of eyes following radical keratotomy. The experimental evidence presented includes measurements both before and after radial keratotomy of the eye's: 1) corneal curvature; 2) optical aberrations; 3) modulation transfer function; 4) visual acuity as a function of test beam entry; and 5) disability glare. Together these five lines of evidence demonstrate that pupil size is a key factor influencing both the optical quality of the eye and visual performance.

Cornea↗
PubMed1988

Pupil-sparing oculomotor palsy from midbrain hemorrhage.

Pupil-sparing oculomotor nerve palsy generally results from extraaxial lesions, but it has also been seen with intraaxial infarcts and tumors. This report of a midbrain hemorrhage in a 64-year-old man supports the idea of selective interference with widely separated oculomotor nerve fascicles as the mechanism for intraaxial pupil-sparing oculomotor nerve palsies.

Cerebral Hemorrhage↗
PubMed1985

Effects of aniseikonia, anisometropia, accommodation, retinal illuminance, and pupil size on stereopsis.

The sensitivity of clinical measures of stereoacuity in the detection of interocular differences in retinal images was examined in 50 adults with normal binocularity. Interocular differences in retinal image size (aniseikonia), clarity (anisometropia) and brightness, as well as differences in absolute and relative pupil size (anisocoria) were created in small steps over a large range to determine their effect on threshold levels of stereopsis. Their effect on stereoacuity was measured in both contour (Titmus test) and random dot (Randot test) stereograms. Stereoacuity measured by both types of stereograms decreased in a curvilinear manner for aniseikonic and anisometropic test conditions. Monocular blur caused a more rapid decrease in stereoacuity than induced aniseikonia. Stereoacuity measured by the contour stereogram decreased about 1.8 times faster than that measured by the random dot stereogram during induced aniseikonia and anisometropia. This differential sensitivity suggests that the Titmus test would detect small interocular differences in retinal images more effectively than the Randot test in clinical screening procedures for vision abnormalities. However, both tests can miss clinically significant amounts of aniseikonia and anisometropia, and fail to differentiate the cause of reduced stereopsis. Interocular differences in retinal image brightness and pupil size within a normal physiologic range did not reduce stereopsis to clinically unacceptable levels.

Accommodation, Ocular↗
PubMed1979

Head injury and the dilated pupil.

The significance of the dilated pupil in head injury is discussed. History of this condition and its possible mechanisms are described. Three patient reports are presented with unilateral dilated pupil. The literature on the subject is reviewed. Finally, the diagnostic steps which may be taken to differentiate direct third nerve injury from expanding mass lesion are suggested.

Adult↗
PubMed1983

The pupil and its disorders.

Pertinent information concerning the pupil is provided for the practicing and aspiring neurologist, including anatomy and physiology of the normal pupil, a discussion of pupillary disorders, and unusual pupillary abnormalities.

Adie Syndrome↗
PubMed1983

The pupil in stroke.

Pupil sizes were assessed in 100 patients admitted to an intensive care stroke unit over a 1-year period to determine if differences existed and if anisocoria might help in diagnosis. From life-size photographs the pupil diameters were measured accurately, and clinical information compiled by the neurology staff was studied. Of the 19 patients with anisocoria 13 had a final diagnosis of stroke. This incidence of anisocoria, 16%, is similar to that in a normal population (20%). The side of the mydriasis was unrelated to the site of the lesions except when the stroke was due to a brainstem infarction; then ipsilateral Horner's syndrome occurred.

Adolescent↗
PubMed1995

New matrix formulation of spectacle magnification using pupil magnification. I. High myopia corrected with ophthalmic lenses.

In this paper we have applied the matrix method to calculating spectacle magnification (SM) and relative spectacle magnification (RSM) for myopic eyes corrected with ophthalmic lenses (OLs). We have been able to obtain very simple expressions of the magnifications and analogous values to the ones obtained using other geometric methods. Through the paraxial 2 x 2 object-image matrix for spherical systems, we can calculate the correcting lens pupil matrix (ML) and the corrected ametropic eye pupil matrix (Mca). These two matrices, that is ML and Mca, directly provide the lateral magnification and the lens-eye system's image focal parameters that enable us to easily calculate SM and RSM. The magnifications have been calculated for the case of myopic eyes corrected with OLs, which shows the validity of this method since its results are similar to the ones obtained using other methods. The analysis of other correcting systems such as contact intraocular lenses will be presented in two associated papers (to be published as parts II and III of this review).

Eyeglasses↗
PubMed1996

Effects of topical administration of 0.5% apraclonidine on intraocular pressure, pupil size, and heart rate in clinically normal dogs.

OBJECTIVE: To evaluate the effect of 0.5% apraclonidine on intraocular pressure (IOP), pupil size, and heart rate in clinically normal dogs. DESIGN: Randomized masked saline-controlled case study. ANIMALS: Nine clinically normal conditioned adult dogs of either sex. PROCEDURE: Normal diurnal variation in IOP, pupil size, and resting heart rate were determined from 7 AM to 7 PM (day 1). These measurements were repeated on day 2 after topical application of 60 microliters of 0.5% apraclonidine to 1 randomly chosen eye of each dog. The contralateral eye received saline solution. RESULTS: Compared with the saline-treated fellow eye, mean IOP in the apraclonidine-treated eye was significantly reduced (3.0 mm of Hg, 16%) 8 hours after treatment. Because of mild day-to-day variations in IOP, however, IOP in the apraclonidine-treated eye on day 2 was not significantly different from day-1 baseline values obtained from the same eye. Significant mydriasis (2.1 mm, 29.7%), persisting for up to 8 hours, occurred in apraclonidine-treated eyes. Although apraclonidine did not significantly alter heart rate when all 9 dogs were viewed as a group, 4 dogs experienced a 9 to 19.5% reduction in heart rate 2 hours after treatment. Mild blanching of the conjunctiva occurred in apraclonidine-treated eyes. CONCLUSIONS: Apraclonidine lowered IOP and, in contrast to cats where it causes miosis, induced mydriasis in dogs. Although heart rate generally is unchanged, it may be reduced in select individuals. CLINICAL RELEVANCE: Topically applied 0.5% apraclonidine may be a useful adjunct to other antiglaucoma treatment modalities in dogs, but is unlikely to be effective as the sole agent in most forms of canine glaucoma.

Administration, Topical↗
PubMedDate not supplied

Effects of intense continuous- and impact-type noise on pupil size and visual acuity.

The data obtained from these studies suggest that continuous noise at high levels will produce an increase in arousal, as indicated by pupil size, and that there is a tendency toward adaptation. At lower noise levels the effect is, at most, transitory. This papillary change does not appear to mediate a change in visual acuity. Impact noise such as that used here does not appear to produce reproducible changes in pupil size or visual acuity. For the noise conditions used here, concern for nonauditory sensory effects seems to be unwarranted.

Acoustic Stimulation↗