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PubMed2006

Teachers' and pupils' definitions of bullying.

BACKGROUND: Comparison of teachers' and pupils' definitions of bullying is important for considering the implications for reports of its incidence in schools, for the study of developmental trends in children's and adolescents' perceptions of the phenomenon and for evaluating the effectiveness of interventions designed to combat bullying. AIMS: To investigate the effects of gender, teacher/pupil status and, for pupils, bullied/non-bullied (target/non-target) status and age on the definition of bullying. SAMPLES: Teachers (N=225: 158 women, 67 men) and pupils (N=1,820: 466 boys, 460 girls were 11-12 years old, year 7, and 415 boys, 479 girls were 13-14 years, year 9) in 51 UK secondary schools participated in a questionnaire survey. A total of 557 of the pupils (117 girls and 117 boys aged 11-12 years, and 197 girls and 126 boys aged 13-14 years) reported that they had been bullied at some time in their present school. METHODS: Written questionnaire responses to the question, 'Say what you think bullying is' have been content analysed to derive two sets of categories, one of bullying behaviour and the other of effects of bullying on the target. RESULTS: Regarding both bullying behaviour and the effects of bullying on the target, teachers - by comparison with pupils - have been found to express more comprehensive ideas in their definitions. Specifically, pupils compared with teachers are more likely to restrict their definitions to direct bullying (verbal and/or physical abuse) and are less likely to refer to social exclusion, a power imbalance in the bully's favour and the bully's intention to cause the target hurt or harm and to feel threatened. Analysis of definitions on the bases of sex, pupil age and target/non-target status show that: targets are more likely than non-targets are to refer to the bully's physically and verbally abusive behaviour, and for Year 7 compared with Year 9 pupils, to suggest that bullies socially exclude targets; girls are more likely than boys are to mention verbal abuse and the effects on the target of 'Feels hurt/harm', but boys are more likely than girls are to construe bullying as involving repetition; older pupils are more likely than younger ones are to refer to a power imbalance in the bully's favour but, for bully targets, younger ones compared with older ones are more likely to invoke the idea of social exclusion in their definitions. CONCLUSIONS: The most important implication of the findings of this study that there are important differences between teachers' and pupils' definitions of bullying is that teachers need to listen carefully to what pupils have to say about bullying and work with and help them to develop their conceptions of the phenomenon. Some teachers, too, need to develop their conceptions of bullying.

Adolescent↗

PubMed1993

Knowledge and attitude of healthy high school students toward bronchial asthma and asthmatic pupils.

One hundred sixteen healthy high school pupils were interviewed and completed a questionnaire concerning their knowledge about asthma and their attitude towards asthmatic peers. They were compared with 35 asthmatic pupils studying at the same school. The level of knowledge was quite satisfactory, with the knowledge of the asthmatic pupils being somewhat higher than that of the healthy pupils, but without statistical significance. There was a correlation with the age of the pupils in both groups (p < 0.0001). The source of pupils' knowledge came principally from the media (television and newspapers), the family (talking with parents), treating physicians, and school nurses. The healthy pupils displayed less tolerance toward the asthmatic disease and its limitations on activity than that displayed by the asthmatic pupils (p < 0.001). A correlation was found between the level of knowledge and attitude, with an increased level of knowledge implying a more tolerant attitude. A correlation was also found between tolerant attitudes and increasing age, increasing parental education, and the pupils' behavior marks. The recommendation of the survey is to improve the instruction regarding bronchial asthmatic diseases with classes taught by physicians or nurses. By increasing the knowledge of the healthy pupils at school, their attitudes will be more tolerant and positive toward the asthmatic pupils.

Adolescent↗

PubMed2005

Patient pain during stretching of small pupils in phacoemulsification performed using topical anesthesia.

PURPOSE: To assess the pain experienced by patients with small pupils during pupil stretching in phacoemulsification performed using topical anesthesia. SETTING: Royal Victoria Eye & Ear Hospital and Mater Misericordiae University Hospital, Dublin, Ireland. METHODS: This was a prospective study that included 26 eyes with small pupils requiring mechanical pupil stretching during phacoemulsification cataract surgery performed under topical anesthesia without sedation. RESULTS: The mean pain score for the instillation of anesthetic drops (2.02) was higher than the mean pain score for the pupil stretch (1.63), but this difference was not significant (signed rank test = -32; P = .2738). There was no significant correlation between the duration of surgery and the overall pain score (r = 0.345; P = .08). There was no significant correlation between change in pupil size and either the pupil stretch score (r = -0.069; P = .74) or the overall pain score (r = -0.032; P = .8739). CONCLUSIONS: Pupil stretching during phacoemulsification in patients with small pupils was performed with minimal patient-reported pain using topical anesthesia. Stretching small pupils with a mechanical device during phacoemulsification performed under topical anesthesia was a safe procedure and did not result in significant patient discomfort.

Aged↗

PubMed2003

Pupil light reflex in normal and diseased eyes: diagnosis of visual dysfunction using waveform partitioning.

OBJECTIVE: To evaluate changes in pupil size (corresponding to neuronal firing) within different time windows of the pupil light reflex in patients and normal subjects to understand which segments of the pupil waveform are best able to differentiate normal from abnormal subjects. DESIGN: Comparative, observational case series. PARTICIPANTS: Forty-nine normal subjects and 25 patients with known unilateral or asymmetric visual field damage were tested. METHODS: A dual-channel infrared pupillograph was used to simultaneously record the right and left pupil diameters at a rate of 60 Hz. Each eye was stimulated alternately (30 degrees full-field, 200 milliseconds duration every 3 seconds) over 10 different stimulus intensities. The recorded waveform of the pupil light reflex was subdivided into six time windows based on landmarks corresponding to contraction onset, maximum contraction velocity, peak contraction, and maximum dilation velocity to assess which portion was most affected by disease. MAIN OUTCOME MEASURES: The linear correlation between pupil contractions elicited by right versus left full-field stimulation at different light intensities provided diagnostic parameters (slope, intercept, and correlation coefficient R(2)) that were useful for differentiating normal subjects from patients and for categorizing disease. Sensitivity and specificity of the time windows were evaluated with receiver-operator curve analysis. RESULTS: The diagnosis of asymmetric disease was greatest at time windows that included pupil contraction but not dilation. When the contraction phase was subdivided into an early phase and into a late phase, the late phase was the most diagnostic compared with the entire phase of contraction amplitude (onset to peak contraction). CONCLUSIONS: By use of a range of light intensity, the change in pupil size measured between the time at which maximum contraction velocity occurs and the time to peak contraction provided the best response parameter for objective diagnosis of asymmetric disease of the anterior visual pathway. The waveform of the pupil light reflex may be an expression of the firing of retinal ganglion cells. Therefore, understanding which segment of the pupil light reflex provides maximal diagnostic power may give insight into how disease affects the pattern of neuronal firing rate.

Diagnostic Techniques, Ophthalmological↗

PubMed1994

Effect of pupil size and astigmatism on contrast acuity with monofocal and bifocal intraocular lenses.

We conducted a bicenter study to evaluate the effect of pupil size and corneal astigmatism on best corrected contrast acuity (BCCA) in patients with the True Vista bifocal intraocular lens (IOL) and compared the results with those in a matched group of monofocal patients. Best corrected contrast acuity was measured using the Regan Charts (96%, 50%, 25%, 11%) at four pupil sizes (2.0, 2.5, 3.5, 6.0 mm) in three groups (Group 1: corneal astigmatism 0-0.50 D [n = 11]; Group 2: 0.75-1.50 D [n = 11]; Group 3: 1.75-2.50 D [n = 4]). In monofocal eyes, BCCA between these astigmatic groups did not differ significantly at any contrast step or at any pupil size tested. However, BCCA decreased slightly with increasing pupil size in each group, and differences between 2.00 mm and 6.0 mm pupils were significant at each contrast level. In all bifocal groups, BCCA decreased significantly with increasing pupil size and also decreased with increasing corneal astigmatism; differences were significant at most pupil sizes and contrasts tested. In Group 1, BCCA was lower in eyes with bifocal IOLs than in eyes with monofocal IOLs at 25% and 11% contrast with a 2.5, 3.5, and 6.0 mm pupil; with a 2.0 mm pupil it did not differ significantly. In Groups 2 and 3, BCCA in eyes with bifocal IOLs was lower at all contrast steps and all pupil sizes tested. Our results indicate that corneal astigmatism in excess of 0.50 D reduces quality of vision in eyes with bifocal IOLs, while eyes with monofocal IOLs are not affected.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1996

Changes in pupil size induced by phacoemulsification and posterior chamber lens implantation: consequences for multifocal lenses.

PURPOSE: Because the optical performance of eyes implanted with multifocal intraocular lenses will theoretically depend upon the size and position of the pupil relative to the near and distance zones of the lens, we designed a study to determine whether preoperative pupil size is useful in predicting the postoperative pupil size of patients having phacoemulsification with posterior chamber lens implantation. SETTING: Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas. METHODS: We prospectively measured pupil sizes preoperatively and postoperatively in 71 consecutive patients who had phacoemulsification with posterior chamber lens implantation. Pupil sizes were photographed under five lighting and viewing conditions that simulated a range of normal functional situations. RESULTS: The mean change in preoperative to postoperative pupil size was less than 0.5 mm in all five testing conditions. However, changes in pupil diameter of 1.0 mm or more were noted in approximately 10% of patients in each testing situation. Sex, iris color, and the presence or absence of intraoperative iris trauma were not predictive factors for determining which patients sustained large postoperative changes in pupil size. CONCLUSIONS: Preoperative pupil size does not predict postoperative size with sufficient consistency to ensure a good match between pupil diameter and the zone sizes of multizone multifocal intraocular lenses.

Follow-Up Studies↗

PubMed1992

[Changes of pupil size in brain death patients].

The representative criteria of brain death in Japan is Takeuchi Criteria (Koseisho Criteria), which is the definition of irreversible loss of brain function (functional brain death). The 3rd item of that criteria is "fixed pupil" and pupil size more than 4 mm. The 4th item is loss of the brain nerve reflexes including the light reflex. Three cases of brain death by whole brain destruction (organic brain death) who showed slow changes of pupil size were reported. Except fixed pupil, one case fulfilled Takeuchi Criteria. Other two cases fulfilled all items of Takeuchi Criteria, showing the same pupil size accidentally at the first and the second judgements. But, they changed their pupil size slowly and continuously after the examinations, showing tendencies toward mydriasis and/or miosis, repeatedly. They never decreased their pupil size less than 4 mm. The changes of pupil size were so slow that we could recognize them only after several hours or several days, and they were quite different from the light reflex. They did not receive any influences from turnover of day and night, darkness of the room, dopamine, etc. For the changes of pupil size were observed in the cases of organic brain death, it was elucidated that they were not due to the brain nerve activity. Then, it was considered that the changes of pupil size in the cases of functional brain death should be the same phenomena, because brain nerve function was lost.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1996

Addiction among high school pupils in Holon (Israel) and their attitudes towards drugs: a pilot study (1993-1994).

One-hundred-and-twenty-five high school pupils aged 14-17 years had completed anonymous questionnaires dealing with smoking habits and alcohol consumption, as well as with the knowledge and attitudes towards drug addiction. Twenty-four percent of the pupils smoked regularly; the age of onset of smoking was 13.93 +/- 1.53 years. Thirty-one percent of the pupils admitted to the regular drinking of alcoholic beverages (including beer, wine, and other alcoholic beverages); the age of onset of drink was 14.65 +/- 0.79 years. The pupils' knowledge concerning drugs was relatively low (scoring of 37.78 +/- 16.87 percent). Pupils in the 16-17-year age group proved to have the highest knowledge. Pupils who used to take drugs received a higher score for their knowledge than other pupils in their classes. Most pupils presented conservative attitudes towards drugs; pupils in the 16-17-year age group received the highest (most liberal) scores; higher (liberal) scores correlated with parental familial status (cohesion) (P = 0.029) and inversely correlated with the behavior marks (r = 0.294; P = 0.03). The attitude of addicted pupils (to cigarettes, alcohol and drugs) was more liberal in comparison with their peers (P < 0.003).

Adolescent↗

PubMed1998

Teachers as significant others: gender differences in secondary school pupils' perceptions.

BACKGROUND: Numerous studies refer to the impact of parents and friends as significant others for adolescents. Given the unique nature of the relationships between teachers and their pupils and their intensive everyday interactions, the present study focuses on a not yet covered topic, namely the meanings that adolescents attach to the significance of their teachers. AIMS: This study was aimed at examining gender differences in secondary school pupils' perceptions regarding positive and negative aspects of the significance of their teachers, and to investigate the possible different domains in which teachers as compared with parents and friends might be significant for the adolescents. SAMPLES: A total of 297 Israeli secondary school pupils (approximately 57 per cent girls and 43 per cent boys) studying in 12 tenth grade classes (age modal 16) participated in this study. METHODS: A questionnaire dealing with pupils' perceptions of significant teachers was administered. Pupils were asked to indicate the extent to which significant teachers are characterised by various descriptors (it was defined for the pupils that a significant teacher is one whom the pupil perceives as having an important influence on her/him). In addition pupils were asked to answer two open-ended questions regarding the domains in which teachers, as compared to their parents and their friends, might be significant for them. RESULTS: Findings showed that the most frequently mentioned characteristics of significant teachers were: teachers who 'take pupils seriously', 'have confidence in them', 'make it easier for them to understand things' and 'push them to do well'. It was also found that girls, more than boys, characterise significant teachers as facilitating learning and relationships; and that boys, more than girls, perceive significant teachers as obstructing their personal development. CONCLUSIONS: Our findings allude to the high potential that teachers may have for impact on their pupils, beyond the domain of learning alone, and provide support for the existence of differential perceptions of significant teachers among boys and girls. These gender differences were explained in terms of the different character of teachers' interaction with the two sexes, and the fact that in the Israeli educational system more than 80 per cent of the teaching staff are women.

Adolescent↗

PubMed2003

[Diet evaluation of senior high school pupils from Mazowiecki region in relation to their place of residence].

The aim of the study was to evaluate diet of pupils of upper secondary schools and to investigate the relation between participants' place of residence and their diet. The study was carried out in 2001; information were collected from 1378 pupils of second classes (822 girls and 556 boys) from 60 upper secondary schools of Mazowieckie region, chosen at random (12% of all upper secondary schools in the region). Dietary assessment was performed on the basis of 24 hrs recall. Analysis was conducted on three groups of pupils: Warsaw inhabitants (25%), smaller towns inhabitants (51%) and country inhabitants (24%). It has been stated, that pupils living in Warsaw, more often than pupils from the other two groups, consumed at least tree so called "full" meals a day (with animal protein and vegetables and/or fruits). They had more often their "full" firsts breakfasts, second breakfasts, suppers and at least three meals containing animal protein as well. The daily menu of pupils from Warsaw contained milk and milk products, fishes and whole grain products more often than diet of pupils from both other groups. Between the groups of youth under investigation there was no significant differences concerning number of daily meals and their regularity. Basing on classes of nutritional adequacy (four classes of diet correctness) it has been stated that pupils living in Warsaw more often than pupils from smaller towns belonged to the first (proper diet) or the second (diet with errors) class of diet. It follows that the diet of upper secondary schools pupils depends on their place of living. Analyses presented here form a part of bigger investigations aiming at establishing different social factors that determine contemporary youth's lifestyle.

Adolescent↗

PubMed2004

Comparison of pupil responses to luminance and colour in severe optic neuritis.

OBJECTIVE: The pupil response to light flux increments is abnormal in severe optic neuritis, but little is known about the effects of this condition on the pupil colour response. The aim of this study was to examine how optic neuritis affects pupil responses to light flux and colour modulation and the extent to which such pupil responses mirror the loss and recovery of vision. METHODS: A new pupil examination technique that makes use of sinusoidal modulation of either luminance contrast or chromatic saturation was employed. This technique enables the automatic extraction of both pupil response amplitude and latency and achieves a high signal to noise ratio with fewer averages. RESULTS: The study reveals a greater loss of pupil response amplitude and significantly longer latencies to chromatic modulation (i.e. approximately 80 ms). Stimulation of the unaffected eye in the optic neuritis group results in smaller response amplitudes when compared to the normal group for both light flux and colour modulation. CONCLUSIONS: Pupil response components can be affected differently in optic neuritis. These findings suggest that the pupil colour response, in particular, may provide a useful, objective estimator to judge the extent of damage and recovery in diseases of the optic nerve.

Adult↗

PubMed2005

Modulation transfer function and pupil size in multifocal and monofocal intraocular lenses in vitro.

PURPOSE: To investigate the relationship between pupil size and the modulation transfer function (MTF) of a multifocal intraocular lens (IOL) in vitro and to predict the visual effects in vivo. SETTING: Department of Ophthalmology and Visual Science, Kitasato University Graduate School of Medical Sciences, Kitasato, Japan. METHODS: A refractive multifocal IOL (Array SA-40N, Allergan) and a monofocal IOL (PhacoFlex SI-40NB, AMO) were evaluated using the OPAL Vector system and a model eye with a variable effective aperture. With effective pupil diameters of 2.1, 3.0, 3.4, 3.9, 4.6, 5.1, and 5.5 mm, the in-focus and defocus MTFs were measured in the multifocal and monofocal IOLs. RESULTS: With increases in effective pupil diameter, the far MTF progressively decreased at all spatial frequencies. In contrast, the near MTF began to increase at effective pupil diameter 2.1 mm, showed a peak at 3.4 mm, and decreased at diameters greater than 3.4 mm. The ratio of near MTF to far MTF showed an increase with larger effective pupil diameters and at lower spatial frequencies. CONCLUSIONS: With a zonal progressive multifocal IOL, the pupil size effected a trade-off between the far and near MTFs: The near MTF increased at the expense of the far MTF at large pupil sizes (effective pupil diameter >3.4 mm). To enhance near vision with a multifocal IOL, the desirable effective pupil diameter should be 3.4 mm or larger.

Contrast Sensitivity↗

PubMed1999

Robust pupil center detection using a curvature algorithm.

Determining the pupil center is fundamental for calculating eye orientation in video-based systems. Existing techniques are error prone and not robust because eyelids, eyelashes, corneal reflections or shadows in many instances occlude the pupil. We have developed a new algorithm which utilizes curvature characteristics of the pupil boundary to eliminate these artifacts. Pupil center is computed based solely on points related to the pupil boundary. For each boundary point, a curvature value is computed. Occlusion of the boundary induces characteristic peaks in the curvature function. Curvature values for normal pupil sizes were determined and a threshold was found which together with heuristics discriminated normal from abnormal curvature. Remaining boundary points were fit with an ellipse using a least squares error criterion. The center of the ellipse is an estimate of the pupil center. This technique is robust and accurately estimates pupil center with less than 40% of the pupil boundary points visible.

Algorithms↗

PubMed1999

The relationship between pupil diameter and pain by the administration of morphine and antidepressant drugs in mice.

Because the pain sensation is subjective, it is difficult to evaluate the responses to analgesic drugs. Some analgesics that affect the central nervous system are known to change the pupil diameter. The pupil diameter is a more objective criterion that shows the drug effect. We studied the relation between the pupil diameter and analgesia responses to morphine and antidepressants by using the selective micro-receptor agonist morphine (2 and 4 mg/kg), the noradrenaline reuptake inhibitor desipramine (7.5 and 10 mg/kg), the mixed serotonergic and noradrenergic uptake inhibitor and cholinergic receptor antagonist amitriptyline (2.5 and 5 mg/kg), and the selective serotonin reuptake inhibitor sertraline (2.5 and 5 mg/kg) in mice. Both monocular microscopy to assess pupil measurement and the hot-plate test to assess nociceptive thresholds were used in the same animals. We found that morphine played an important role in both mydriasis and analgesia, whereas amitriptyline and desipramine had a greater effect on pupil response than on nociception. Sertraline produced antinociception without causing a change in pupil diameter. As a result, although the pupil response is an important criterion in evaluating the analgesic effect of morphine, it is not possible to put forward the same criterion for the antidepressant drugs. Because different neurotransmitters are involved in pupil and pain mechanisms of antidepressant drugs, it is difficult to evaluate the analgesic response with the pupil diameter.

Amitriptyline↗

PubMed2002

Pupil diameter changes and reaction after posterior chamber phakic intraocular lens implantation.

PURPOSE: To compare the different aspects of pupil constriction before and after the implantation of an implantable contact lens (ICL). SETTING: Augenabteilung der Schlosspark-Klinik Berlin, Berlin, Germany. METHODS: This study comprised 15 myopic and 9 hyperopic eyes that were evaluated before and after the implantation of an ICL using a compact integrated pupillograph (CIP, AMTech) under standardized conditions. The preoperative and postoperative pupil diameters, rate and latency of the pupil reaction, and amplitude of constriction were compared. RESULTS: The latency and the duration of pupil constriction were significantly prolonged after ICL implantation. The rate of pupil contraction and redilation, the pupil diameter, and the amplitude of pupil constriction were reduced after ICL implantation. CONCLUSIONS: The pupil reaction after implantation of a phakic posterior chamber ICL was slower. The postoperative pupil diameter was smaller, and the amplitude of constriction was reduced. The changes have not proved to be clinically significant to date.

Female↗

PubMed2004

Pupil assessment in optic nerve disorders.

BACKGROUND: The normal pupillary constriction to light is an involuntary reflex that can be easily elicited and observed without specialized equipment or discomfort to the patient. Attenuation of this reflex in optic nerve disorders was first described 120 years ago. Since then, pupil examination has become a routine part of the assessment of optic nerve disease. CLINICAL TECHNIQUES: The original cover/uncover test compares pupillomotor drive in the two eyes, but requires two working pupils and is relatively insensitive. The swinging flashlight test is now the standard clinical tool to detect pupillomotor asymmetry. It requires only one working pupil, is easily quantified, and has high sensitivity in experienced hands, but interpretation of the results needs care. Measurement of the pupil cycle time is the only clinical test that does not rely on comparison with the fellow eye, but it can only be measured in mild to moderate optic nerve dysfunction, is more time consuming, and less sensitive. LABORATORY TECHNIQUES: Infrared video pupillography allows recordings to be made of the pupil responses to full-field or perimetric light stimulation under tightly controlled conditions with a high degree of accuracy. Frustratingly, there is a wide range in reflex gain in normal subjects limiting its usefulness unless comparison is made with the fellow eye or stimulation of unaffected adjacent areas of the visual field. CORRELATION WITH OTHER TESTS: In general, pupillomotor deficit shows good correlation with visual field deficit. However, some diseases of the optic nerve are associated with relative sparing either of pupil function or visual function implying that pupil tests and psychophysical tests may assess function in different subpopulations of optic nerve fibres. Less is known of the relationship between pupil measurements and electrodiagnostic tests. USES IN CLINICAL PRACTICE: Pupil assessment is invaluable when distinguishing functional from organic visual loss. Its usefulness in distinguishing between different causes of optic neuropathy and as a prognostic sign is gradually emerging.

Evoked Potentials, Visual↗

PubMed2002

Normal values and standard deviations for pupil diameter and interpupillary distance in subjects aged 1 month to 19 years.

Normal values of pupil diameters and interpupillary distances (PDs) were measured in a population of 1311 subjects (in 4294 visits) ranging from 1 month of age to slightly over 19 years of age. Subjects in this study were recruited from birth announcements in a local newspaper for a developmental vision project. Pupil sizes were measured photographically when the corneas were illuminated by 15.9 +/- 0.5 lux ambient illumination (i.e. under mesopic conditions). Interpupillary distance was measured with an interocular distance rule while the subject fixated an object at 0.66 m distance. These PD measurements were corrected for systematic measurement errors and to an infinite viewing distance using radii of ocular rotation based on age-dependent axial lengths. Means and S.D. were calculated for age, pupil diameter and PD for each 1-year group of male and female subjects. The second order regression equation for average pupil size as a function of age was determined: [males pupil diameter (in mm) = 5.83 +/- 0.181*age in years - 0053*age in years2, r2 = 0.897; female pupil diameter = 5.40 + 0.285*age in years - 0.0109*age in years2, r2 = 0.945]. The dierence between male and female pupil sizes (mean male - female = 0.13 mm) was marginally not significant (p < 0.054). The average corrected PDs as a function of age were found to approximate another second-order regression equation: (males PD = 43.36 + 1.663*age in years - 0.034*age in years2, r2 = 0.986; females PD = 41.76 + 1.891 *age in years - 0.052*age in years2, r2 = 0.986). Male PD was wider than female PD by an average of 1.58 mm (p < 0.0003). As expected, the results of this study were similar to a preliminary investigation conducted by Thunyalukul et al. [Invest. Ophthalmol. Vis. Sci. 37 (1996) S731] on a portion of the present data set, and also very similar to data from another study of comparable racial composition using a different measurement method [Pryor, Pediatrics 44 (1969) 973]. It was concluded that pupil diameter and PD increase more gradually than axial length of the eye in the first few years of life. The normal values and S.D. for both pupil size and PD determined in this study have important clinical implications as well as applications in the optical industry.

Adolescent↗

PubMed2006

The Argyll Robertson pupil.

The Argyll Robertson (AR) pupil has been defined as a pupil that is small and constricts poorly to direct light but briskly when a target within reading distance is viewed ("light-near dissociation"). Most descriptions of the AR pupil do not mention segmental iris sphincter constriction, or slow, sustained constriction with a near vision effort. Such features are considered typical of the light-near dissociation of Adie syndrome and of neuropathic tonic pupils, where damage to the ciliary ganglion or ciliary nerves is believed to be the mechanism. Because the AR pupil lacks these features, it has been attributed to a dorsal midbrain lesion that interrupts the pupillary light reflex pathway but spares the more ventral pupillary near reflex pathway. However, lesions in this region have not been reliably demonstrated in syphilis. Resolving the issue about the location of the syphilitic lesion that produces the AR pupil will depend on careful examination of patients with techniques designed to disclose segmental palsy of the iris. If segmental iris sphincter palsy is found and the light-near dissociation has tonic features, one must conclude that the mechanism of the pupil disorder is a ciliary (peripheral) rather than a midbrain (central) denervation. Until better evidence settles the localization of the AR pupil, it is appropriate to screen patients with bilateral tonic pupils for syphilis.

Humans↗