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At least 19 recordsLinked to original sources
PubMed2004

Comparison of various pupil dilatation methods for phacoemulsification in eyes with a small pupil secondary to pseudoexfoliation.

PURPOSE: To compare 4 methods for intraoperative pupil dilatation in eyes with pseudoexfoliation syndrome and insufficient pupil size during phacoemulsification. DESIGN: Prospective, randomized, comparative, interventional case series. PARTICIPANTS: Forty eyes of 40 patients with pseudoexfoliation and maximally dilated pupil size smaller than 3.5 mm. INTERVENTION: Mechanical pupil dilatation with iris-retractor hooks (group I), polymethyl methacrylate (PMMA) pupil dilator-ring (Morcher, Stuttgart, Germany) (group II), Beehler pupil dilator (group III), and bimanual stretching (group IV). MAIN OUTCOME MEASURES: Performance (pupil size achieved), complications, and added surgical time. RESULTS: The mean pupil sizes achieved with the PMMA pupil-dilator ring, Beehler pupil dilator, and bimanual stretching were 5.9+/-0.6 mm, 5.5+/-0.8 mm, and 4.9+/-0.7 mm, respectively. A square-shaped pupil was achieved with iris-retractor hooks, and the mean size of the largest circle that can fit in this square was 5.6+/-0.6 mm. There were no statistically significant differences in the postdilatation pupil sizes between the 4 study groups (P>0.05). Apart from self-limited intraoperative hemorrhage from pupil margin, iris sphincter rupture was the only observed complication related to mechanical pupil dilatation. This occurred in 4 eyes in groups I and III, 3 eyes in group IV, and 1 eye in group II (P>0.05). The mean added surgical time for placement of iris-retractor hooks and for implantation of a PMMA pupil-dilator ring was 297+/-51 and 176+/-54 seconds, respectively. The additional time required for pupil dilatation with the Beehler pupil dilator and bimanual stretching was 65+/-8 and 55+/-10 seconds, respectively. The time needed for pupil dilatation in groups I and II is significantly longer than that in groups III and IV (P<0.001). CONCLUSIONS: All 4 methods used in this study were effective procedures for the mechanical dilatation of small pupils secondary to pseudoexfoliation syndrome. Iris-retractor hooks and the PMMA pupil-dilator ring are the most time-consuming techniques but have the advantage of a stable pupil size throughout the surgery. The PMMA pupil-dilator ring causes the least iris trauma. The Beehler pupil dilator and bimanual stretching technique were the least time-consuming methods for mechanical pupil dilatation.

Aged↗
PubMed2006

Pupil measurement using the Colvard pupillometer and a standard pupil card with a cobalt blue filter penlight.

PURPOSE: To compare scotopic pupil measurements obtained with a Colvard pupillometer with measurements taken with a printed pupil gauge and penlight with a cobalt blue filter attachment in mesopic and scotopic luminance. SETTING: The Illinois Eye Institute, Chicago, Illinois, USA. METHODS: Pupil measurements were taken of both eyes of 38 patients (76 eyes). Any subject presenting with anterior segment disease, fixed or dilated pupils, iris abnormalities, or a history of eye disease or eye trauma was excluded. At a mesopic luminance of 2.11 foot-candles, pupil measurements were taken with a Bernell pupil card and penlight with a cobalt blue filter attachment. At a scotopic luminance of less than 2.00 foot-candles, pupil measurements were taken with the Bernell card system and the Colvard pupillometer. RESULTS: In mesopic luminance, the mean pupil diameter was 5.17 mm (range 3.0 to 7.5 mm) with the Bernell card method. The mean difference between the Colvard in scotopic luminance and the Bernell card system in mesopic luminance was -0.04 mm (P = .0831). In scotopic luminance, the mean pupil diameter was 6.32 mm (range 4.0 to 8.0 mm) with the Bernell card method and 5.13 mm (range 3.0 to 7.5 mm) with the Colvard pupillometer, with a mean difference of -1.18 mm (P<.0001). The limits of agreement between the mesopic Bernell card system and the Colvard pupillometer were small (-0.32 to 0.24), whereas the limits of agreement between the scotopic measurements of both techniques were large (-2.18 to -0.18). CONCLUSIONS: Under both illuminance conditions, the Bernell card system with the cobalt filter measured a larger pupil size than the Colvard pupillometer. The measurement differences between the techniques were most pronounced at the lower illumination. The limits of agreement were larger under the lower illumination, indicating more variation between techniques. This study suggests that the Bernell card system with cobalt illumination provides a generous measurement of the pupil size compared with the Colvard pupillometer, which makes it an appropriate and cost-effective screening tool for refractive surgery evaluation.

Body Weights and Measures↗
PubMed2000

Changes in the aetiology of hearing impairment in deaf-blind pupils and deaf infant pupils at an institute for the deaf.

An aetiological study was performed on 57 pupils at the deaf-blind department of the Institute for the Deaf at Sint-Michielsgestel, The Netherlands, in the school year 1998-1999 and on 49 deaf-blind pupils at the same department in the school year 1986-1987. The pupils were 5-20 years of age. In addition, the aetiologies were studied in 55 deaf infant pupils in 1998 and compared with those of 68 deaf infant pupils in 1988. Their age was 1-5 years. All the pupils showed hearing impairment with thresholds of >60 dB HL. Among the deaf-blind pupils and deaf infant pupils, there were several cases with rare hereditary syndromes. The prevalence of acquired causes of deafness, especially congenital rubella, had decreased over the years, whereas perinatal causes of deafness had increased. Chromosomal anomalies were found in 15% of the infant pupils in 1998. Over the study period, the percentage of pupils with multiple handicaps increased from 25 to 38%.

Adolescent↗
PubMed1998

Pupil-class determinants of aggressive and victim behaviour in pupils.

BACKGROUND: Aggressive behaviour in pupils is expressed in, e.g., bullying, sexual harassment, and violence. Different kinds of variables could be relevant in explaining a pupil's aggressive or victim behaviour. AIMS: To develop a multilevel theoretical and empirical explanation for different kinds of aggressive and victim behaviour displayed by pupils in a classroom and school environment. SAMPLES: A national survey was carried out to identify different kinds of aggressive and victim behaviour displayed by pupils and to assess other variables related to pupils, classes, and schools. A total of 1998 pupils from 100 third and fourth year classes attending 71 different secondary schools took part in the research. METHODS: Data were analysed by a series of secondary multilevel analyses using the MLA-program. RESULTS: Being a boy, being more extravert, being more disagreeable, coming across fewer teachers with positive teaching behaviour, and attending a lower type of secondary school, help explain why someone is a perpetrator as such. Being a boy, being more disagreeable, being more emotionally unstable, being open to new ideas, and seeing more teachers as being strict, function as explanatory pupil variables for victim behaviour. Other pupil level variables determine more specific aggressive and victim behaviour aspects. Various other class level and school level variables are relevant, too. CONCLUSIONS: Personal and environmental pupil variables are more important than class variables but class variables are in turn more important than school variables in explaining a pupil's aggressive and victim behaviour.

Aggression↗
PubMed1996

Graether pupil expander for managing the small pupil during surgery.

The Graether pupil expander, a device for mechanically dilating the pupil, is a soft silicone ring grooved to engage the iris sphincter and maintain pupil dilation during cataract surgery and intraocular lens implantation. The ring is incomplete; the gap is bridged by a slender strap that provides access to the pupil aperture. The pupil expander will be preloaded on a disposable insertion tool that permits the expander to be inserted through the primary surgical incision. Stretching the pupil and placing the pupil expander is facilitated by an iris glide-retractor that fixates the iris sphincter at the incision prior to insertion of the pupil expander. Clinical experience with over 100 cases is briefly discussed.

Cataract Extraction↗
PubMed1999

Promoting prosocial pupil behaviour: 2-secondary school intervention and pupil effects.

BACKGROUND: In an earlier article (Mooij, 1999c) a theoretical multilevel model to promote prosocial pupil behaviour by stimulating specific educational conditions was developed. AIMS: To carry out school interventions to check empirically whether pupil level effects occur because of educational changes at the classroom and school level. SAMPLES: Seven secondary schools with relatively high degrees of pupil aggression were selected. Four schools took part as intervention schools, three schools served as control schools. In 1995 (pretest) and 1997 (post-test) pupils and form teachers of the first and third school years participated by completing questionnaires. Within the pupil cohorts, a longitudinal group of 352 pupils was included. METHODS: Pretest questionnaires in 1995 were followed by intervention in the intervention schools. Teachers collaborated with staff and researchers to increase pupils' participation and responsibility in specifying and controlling behavioural and didactic rules, related to didactic differentiation during lessons. The validity of the intervention implementation was checked using qualitative information and quantitative data from both pre- and post-test. Longitudinal intervention effects were tested by applying two-level multiple regression analyses. RESULTS: After controlling for pretest and covariables in school year 1, school intervention effects were found in school year 3 with the prediction of being a perpetrator of aggressive behaviour at school, aggressive behaviour outside school, and criminal behaviour. Some small effects were found with respect to victim behaviour. CONCLUSIONS: Social-pedagogical and didactic class and school variables, but also home variables and support by peers without problematic behaviour, could be integrated more systematically to promote prosocial development of a pupil's behaviour from the beginning in school.

Adolescent↗
PubMed2006

A binocular pupil model for simulation of relative afferent pupil defects and the swinging flashlight test.

Many important intracranial neural pathways are involved in the control of the two muscles of the human pupil and the observation and analysis of pupil responses to light or other stimuli is of great interest in many clinical procedures. The binocular pupil model presented in this document has a topology encompassing much of the complexity of the pupil system neurophysiology. The dynamic parameters of the model were matched against pupil experiments under multiple conditions. It is employed here to simulate responses to the swinging flashlight test, a procedure which is routinely practiced in ophthalmology to diagnose different degrees of relative afferent pupil defects often a consequence of severe optic nerve diseases or retinal dysfunctions. Other, not light-dependent, pupil stimuli are briefly discussed.

Computer Simulation↗
PubMed1992

The Julius F. Neumueller Award in Optics, 1989: change of pupil centration with change of illumination and pupil size.

Pupil centration is important to the optical blur on the retina. Using a dual Maxwellian view system we measured the centration of the pupil with respect to the achromatic axis of the eye as a function of pupil size. Significant shifts of the pupil center (up to 0.6 mm) with pupil dilation were measured in both nasal and temporal directions. The effect was usually symmetrical between the two eyes and the shift was linear with pupil size in one-half of the subjects. From their initial positions the linear pupil center shifts with dilation were in the direction of the achromatic axis.

Analysis of Variance↗
PubMed1991

Automated pupil perimetry. Pupil field mapping in patients and normal subjects.

The authors developed an automated method of pupil perimetry by linking an infrared video pupillometer to a Humphrey Field Analyzer. Software was developed to automatically analyze the pupil responses to focal light stimuli and display the results graphically. All 76 locations of Humphrey program 30-2 could be tested twice within 5.5 minutes and the relative sensitivity of the field was determined by comparing the amplitude of pupil constriction or latency time at each stimulus location. The mean pupil responses within annular areas at 3 degrees, 9 degrees, 15 degrees, 21 degrees, and 27 degrees were shown to be linearly related to log stimulus intensity over a 15 dB range under low level mesopic conditions (3.15 asb bowl background). In normal subjects, the superior temporal quadrant usually had the greatest mean pupillomotor response and the inferior nasal quadrant had the least. Pupil responses in the temporal field were larger than corresponding locations in the nasal field. Patients with visual field defects who underwent testing by pupil perimetry showed pupillary deficits in the same location within the field, providing evidence that pupil perimetry may be a useful, objective means of assessing visual field function.

Adolescent↗
PubMed1989

Pupils' knowledge of mental handicap: a study of second year pupils in a British comprehensive school.

As a prelude to an awareness course in mental handicap an exploration was made of the relevant cultural knowledge of pupils in the second year of a comprehensive school. The study is in two parts. The first consists of a description of how gender differences emerged as an important theme in interviews with one class of pupils. In the second part the findings of a questionnaire study of 179 second year pupils are described and commented upon. Information was obtained on their experience, images and knowledge of and feelings about mental handicap. Their views on integration could be categorized under five headings (i) a productive learning experience for mentally handicapped pupils (ii) benefits to 'normal' pupils (iii) the need for a special environment (iv) being 'picked on' (v) not a productive learning experience for either party. Boy/girl differences were noted in responses to certain questions. In the discussion section, the implications for the curriculum are drawn out in relation to gender differences, pupils' existing knowledge of mental handicap, pupils' views on the important topic of integration, and language awareness.

Child↗
PubMed2003

[Measurement of scotopic pupils: comparison of scotic pupil measurements using a colvard pupilometer and the slitlamp green light test].

PURPOSE: The aim of the study was to compare the accuracy and the reproducibility of scotopic pupil measurements using two different methods. PATIENTS AND METHODS: We developed a simple test to measure scotopic pupil diameters using a narrow slit of light through a green filter of the Haag-Streit slitlamp. A total of 100 eyes from 50 refractive surgery candidates were prospectively examined by 2 independent investigators using both the Colvard pupilometer (Oasis/USA) and Sekundo's slitlamp green light test. Results were compared using all pairwise multiple comparison procedures (Student-Newman-Keuls method, SigmaStat/Jandel Scientific). The mean age of the patients was 36.3 years with a male:female ratio of 16:34. The colour of the iris was considered blue for 36 individuals and brown for the remainder. RESULTS: Reproducibility: the right eye mean pupil diameter using Sekundo's method was 6.4 mm (+/-0.9) measured by both the first (Slit 1R) and the second (Slit 2R) investigator. The left eye mean pupil diameter was 6.5 mm (+/-1) (Slit 1L) and 6.35 mm (+/-1) (Slit 2L), respectively. The following measurements were obtained with the Colvard pupillometer: (Colv1R)=6.25+/-0.85 mm, (Colv2R)=5.99+/-1 mm, (Colv1L)=6.15+/-0.91 mm, (Colv2L)=6.05+/-0.9 mm. There were no statistically significant differences between the two investigators within the same method of examination. Comparability:The data of both investigators were combined to form 4 groups: (Slit R)=6.4+/-0.96 mm, (Slit L)=6.4+/-1 mm, (Colv R)=6.05+/-0.9 mm, (Colv L)=6.1+/-0.93 mm. There was a significant difference ( p=0.024) between the two methods for both right and left eyes. Particularly for large pupils, the slitlamp green light measurements were significantly higher (up to 0.35 mm) than those with Colvard's device. CONCLUSIONS: The slitlamp green light test provides similar reproducibility for the measurement of the scotopic pupil diameter as the commercially available Colvard pupilometer.

Adult↗
PubMed2002

Comparison of the pupil card and pupillometer in measuring pupil size.

PURPOSE: To determine the difference in pupil size measured with the Colvard pupillometer in mesopic and scotopic luminance and with the Rosenbaum pupil card in mesopic luminance between 2 examiners. SETTING: Michel Pop Clinics, Montreal, Quebec, Canada. METHODS: Two examiners used the Colvard pupillometer and the Rosenbaum card to measure pupil size in 58 eyes. The Colvard pupillometer was used in mesopic and scotopic light conditions. The Rosenbaum card was used in mesopic luminance only. Pupil size was evaluated with a 1.0 mm interval scale at the nearest half millimeter. RESULTS: For the 3 sets of data, the limits of agreement and coefficient of interrater repeatability were calculated and a 2 x 2 factorial analysis of variance was performed. Because of interexaminer bias, measurements done in mesopic luminance with the Rosenbaum card were not statistically different from those with the Colvard pupillometer in scotopic luminance, although interrater repeatability of the Colvard pupillometer (0.8 mm) was superior to that of the Rosenbaum card (1.3 mm). CONCLUSIONS: Examiner bias was the greatest statistical bias in all sets of measures. Surgeons may want to opt for a "safe" limit of pupil size (ie, 0.5 to 0.8 mm greater than the measured size) when calculating optical zones in refractive surgery. Future devices for pupil measurement should be based on automatic adjustment sizing.

Diagnostic Techniques, Ophthalmological↗
PubMed2001

Misalignment of flexible iris hook retractors for small pupil cataract surgery: effects on pupil circumference.

A graphical method was used to assess the effect on pupil shape and circumference of various flexible iris hook malpositions. Results confirmed that all hook malpositions necessitate increased pupil stretching to create space to perform a capsulorhexis of a given diameter. This method also confirmed that the addition of a fifth hook to create a pentagonal pupil reduces pupil stretching by 17%. A simple method of marking the limbus before hook insertion to ensure equidistant hook separation and thus minimize pupil stretching is suggested.

Cataract Extraction↗
PubMed2003

Use of admission Glasgow Coma Score, pupil size, and pupil reactivity to determine outcome for trauma patients.

BACKGROUND: Determination of nonsurvival in trauma patients is difficult because valid prognostic indicators are lacking. It was hypothesized that patients presenting with a Glasgow Coma Score (GCS) of 3 as well as fixed and dilated (FD) pupils do not have a reasonable chance of survival. METHODS: From 1999 through 2001, adult trauma patients (age, >14 years) admitted with a GCS of 3 were reviewed. Patients receiving paralytic agents before initial assessment were excluded from analysis. Fixed and dilated pupils were defined as being 4 mm or more in diameter bilaterally and nonreactive to light. In this study, the FD patients were evaluated for survival, resuscitative measures, surgical procedures, length of hospital stay, and organ donation. The non-FD patients were evaluated for survival and length of hospital stay. RESULTS: Of the 137 patients evaluated with a GCS of 3, 104 had FD pupils and 33 did not. In the FD group, there were no survivors. On arrival, 28 (37.3%) of the patients were declared dead, and no further interventions were undertaken. Of the 76 patients (62.7%) who underwent further resuscitation, which included 53 surgical procedures, 30 died in the resuscitation bay, 39 within 24 hours, 4 within 48 hours, 2 within 72 hours, and 1 on day 6. There were 18 (23.7%) organ donors. Of the 33 patients without FD pupils, 11 (33%) survived to discharge (mean hospital stay, 21.4 days). Of the 22 nonsurvivors (67%), 10 died in the resuscitation bay, 8 within 24 hours, 1 within 48 hours, 1 on day 4, and 2 on day 6. CONCLUSIONS: Patients presenting with a GCS of 3 and FD pupils have no reasonable chance for survival. A significant percentage of these patients can be salvaged for organ donation. This information should be used in deciding to pursue aggressive resuscitation efforts and in discussing prognosis with family. Patients with a GCS of 3 who are not FD should be aggressively resuscitated because many of these patients survive to discharge.

Adolescent↗
PubMed2005

Depressive symptoms in adolescent pupils are heavily influenced by the school they go to. A study of 10th grade pupils in Oslo, Norway.

BACKGROUND: A school is generally acknowledged to be a key setting for promoting pupils' health and well-being. METHODS: Data from a cross-sectional questionnaire study conducted with all 10th grade pupils in 46 public schools. Depressive symptoms was defined by a positive score on Hopkin's Symptom Check List-10 (HSCL-10). Two composite variables expressing risk were established: (i) presence of negative factors (PNF), consisting of self-reported pressure to succeed, sexual violation, and exposure to bullying and violence; and (ii) absence of positive factors (APF), comprising respondents' self-reported physical activity, educational aspirations, and family's valuing their opinions. RESULTS: Out of 7505 pupils, complete data were obtained for 6207. The prevalence of symptoms of depression varied greatly among different schools (boys, from 0 to 19%; girls, from 3.3 to 39%). The PNF varied from 12.3 to 45.5% for boys, and from 4.2 to 38.8% for girls. Corresponding figures for APF were 2.4-23.1% for boys and 4.3-37.5% for girls. Among boys, we found significant associations between PNF and symptoms of depression, odds ratio (95% CI) 4.5 (3.5-5.8), and between APF and depressive symptoms, 3.1 (2.3-4.1). For girls, corresponding odds ratios were 3.5 (2.9-4.2) and 2.1 (1.7-2.6), respectively. CONCLUSIONS: The proportion of pupils with depressive symptoms varies greatly among Oslo public schools. This variation is associated with features of the pupils' social context.

Adolescent↗
PubMed2005

Comparison of dynamic digital pupillometry and static measurements of pupil size in determining scotopic pupil size before refractive surgery.

PURPOSE: To compare 2 digital infrared pupillometers. SETTING: Anterior Segment Service, Moorfields Eye Hospital, London, England. METHODS: Eighty-eight eyes of 44 healthy subjects were recruited into the study. The scotopic pupil size was measured with 2 instruments, a digital pupillometer (Procyon) and a Hartman-Shack wavefront aberrometer (Visx WaveScan). Agreement between the instruments was assessed. RESULTS: There were 21 men and 23 women with a mean age 38.1 years +/- 9.2 (SD) (range 23 to 62 years). The mean scotopic pupil diameter was significantly larger with the WaveScan (6.61 +/- 0.92 mm) than with the Procyon pupillometer (6.40 +/- 0.90 mm), P<.001. CONCLUSIONS: There was good agreement in measurement of scotopic pupil size between the two instruments. The larger pupil diameter found with the Visx WaveScan than with the Procyon digital pupillometer probably represents the different illumination level used by each instrument, the effects of accommodation, and target fogging.

Adult↗
PubMed1981

Influence of central depressant drugs on pupil function: an evaluation with the pupil cycle induction test.

Afferent pupillary defect is an early sign of optic nerve or chiasm disease. It can be evaluated by the Pupil Cycle Induction Test (PCIT) which assesses the difficulty in setting up regular and sustained pupil oscillations. PCIT was carried out in 30 subjects with presumably normal visual function (normal visual acuity and normal fundi) and taking benzodiazepines and/or barbiturates. In 42 out of the 60 tested eyes, response to PCIT was altered. This emphasizes the necessity of a detailed drug-taking history when investigating anterior visual pathways by means of pupil function, especially when one considers the extensive use of central nervous system depressant drugs by the general population.

Adolescent↗