Department of Ophthalmology, School of Medicine, Kitasato University.
Pupil is richly innervated by autonomic nerves. Therefore, its size or movement well reflects the autonomic nervous function. By analyzing dynamics of pupil movement for light stimulus followed by infrared video-pupillography, the abnormality of autonomic nervous system can be expressed in a quantitative manner. Clinical applications of pupillography and pharmacological examination to Horner syndrome, Adie syndrome, diabetes mellitus, pupillary involvement of Behcet disease, pupil of brain death and patients with chemical sensitivity have been described. Segmental spasm of iris in Horner and Aide syndrome, especially, nasal side of iridoplegia was seen in early stage of Aide syndrome from pupillary dynamics to light stimulus. An involvement of sympathetic nerve subserving iris dilator muscle was confirmed from pupillography, drug reaction to topically applied l-epinephrine in the diabetics. An involvement of cholinergic nerve which subserve the iris sphincter muscle was seen in Behcet disease when there was no manifest eye involvement. Mild mydriasis in brain death patients was seen under denervation of central nervous system. Dysfunction of sympathetic nerve from pupillary light reflex in chemically sensitive patients for cholinated hydrocarbon pesticides.
PMID: 1619750 [PubMed - indexed for MEDLINE]
