Quantitative pupillometry: normative data in healthy pediatric volunteers

Restricted access

Object

The authors describe the prospective use of a new hand-held point-and-shoot pupillometer (NeurOptics) to assess pupil function quantitatively.

Methods

Repetitive measurements were made in 90 pediatric participants ranging in age from 1 to 18 years, providing a total of 100 measurements under ambient light conditions. The participants consisted of 45 patients without known intracranial or ophthalmological pathological conditions as well as 45 volunteers in the outpatient setting. Quantitative pupil measurements were reliably replicated in the study participants. The mean resting pupil aperture was 4.11 mm and the minimal diameter after stimulation was 2.65 mm, resulting in a 36% change in pupil size. The mean constriction velocity was 2.34 mm/second, with a mean dilation velocity of 2.2 mm/second.

Conclusion

Pupil symmetry was impressive in the entire cohort.

Article Information

Address reprint requests to: Kostas N. Fountas, M.D., Ph.D., 840 Pine Street, Suite 880, Macon, Georgia 31201. email: knfountasmd@excite.com.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    Photograph of the NeurOptics pupillometer.

  • View in gallery

    Close-up photograph of the pupillometer's LCD data display.

  • View in gallery

    Bar graph of average pupil resting diameter by age group. The numbers above each bar refer to the average diameter (millimeters) of the pupil without light stimulation in the various age groups. N = number of patients.

  • View in gallery

    Bar graph of average pupil aperture after light stimulation by age group. The numbers above each bar refer to the average pupil aperture (millimeters) after light stimulation in each group of participants.

  • View in gallery

    Bar graph of the average percentage of change in pupil diameter by age group. The numbers above each bar reflect the average percentage of reduction in pupil diameter after light stimulation in each age group.

  • View in gallery

    Bar graph of average latency of pupil response to light by age group. The numbers above each bar reflect the average time (milliseconds) elapsed before a pupil response was elicited after light stimulation in each age group.

References

1.

Andrews BTPitts LH: Functional recovery after traumatic transtentorial herniation. Neurosurgery 29:2272311991Andrews BT Pitts LH: Functional recovery after traumatic transtentorial herniation. Neurosurgery 29:227–231 1991

2.

Blumenfeld H: Neuroanatomy Through Clinical Cases. Sunderland, MA: Sinauer2002 p 541Blumenfeld H: Neuroanatomy Through Clinical Cases. Sunderland MA: Sinauer 2002 p 541

3.

Braakman R: Interactions between factors determining prognosis in populations of patients with severe head injury. Adv Neurosurg 5:12151978Braakman R: Interactions between factors determining prognosis in populations of patients with severe head injury. Adv Neurosurg 5:12–15 1978

4.

Braakman RGelpke GJHabbema JDMaas AIMinderhoud JM: Systematic selection of prognostic features in patients with severe head injury. Neurosurgery 6:3623701980Braakman R Gelpke GJ Habbema JD Maas AI Minderhoud JM: Systematic selection of prognostic features in patients with severe head injury. Neurosurgery 6:362–370 1980

5.

Cordobes FLabato RDRivas JJMunoz MJChillon DPortillo JMet al: Observations on 82 patients with extradural hematoma. Comparison of results before and after the advent of computerized tomography. J Neurosurg 54:1791861981Cordobes F Labato RD Rivas JJ Munoz MJ Chillon D Portillo JM et al: Observations on 82 patients with extradural hematoma. Comparison of results before and after the advent of computerized tomography. J Neurosurg 54:179–186 1981

6.

Fisher CM: Oval pupils. Arch Neurol 37:5025031980Fisher CM: Oval pupils. Arch Neurol 37:502–503 1980

7.

Heiden JSSmall RCaton WWeiss MKurze T: Severe head injury. Clinical assessment and outcome. Phys Ther 63:194619511983Heiden JS Small R Caton W Weiss M Kurze T: Severe head injury. Clinical assessment and outcome. Phys Ther 63:1946–1951 1983

8.

International Commission on Non-Ionizing Radiation Protection: Guidelines on limits of exposure to broad-band incoherent optical radiation (0.38 to 3 µM).Health Phys 73:5395541997International Commission on Non-Ionizing Radiation Protection: Guidelines on limits of exposure to broad-band incoherent optical radiation (0.38 to 3 µM). Health Phys 73:539–554 1997

9.

Jennett BTeasdale GBraakman RMinderhoud JHeiden JKurze T: Prognosis of patients with severe head injury. Neurosurgery 4:2832891979Jennett B Teasdale G Braakman R Minderhoud J Heiden J Kurze T: Prognosis of patients with severe head injury. Neurosurgery 4:283–289 1979

10.

Jennett BTeasdale GBraakman RMinderhoud JKnill-Jones R: Predicting outcome in individual patients after severe head injury. Lancet 1:103110341976Jennett B Teasdale G Braakman R Minderhoud J Knill-Jones R: Predicting outcome in individual patients after severe head injury. Lancet 1:1031–1034 1976

11.

Kandel ERSchwartz JHJessell TM (eds): Principles of Neural Scienceed 4. New York: McGraw-Hill2000Kandel ER Schwartz JH Jessell TM (eds): Principles of Neural Science ed 4. New York: McGraw-Hill 2000

12.

Marshall LFBarba DToole BMBowers SA: The oval pupil: clinical significance and relationship to intracranial hypertension. J Neurosurg 58:5665681983Marshall LF Barba D Toole BM Bowers SA: The oval pupil: clinical significance and relationship to intracranial hypertension. J Neurosurg 58:566–568 1983

13.

Taylor WRChen JWMeltzer HGennarelli TAKelbch CKnowlton Set al: Quantitative pupillometry, a new technology: normative data and preliminary observations in patients with acute head injury. Technical note. J Neurosurg 98:2052132003Taylor WR Chen JW Meltzer H Gennarelli TA Kelbch C Knowlton S et al: Quantitative pupillometry a new technology: normative data and preliminary observations in patients with acute head injury. Technical note. J Neurosurg 98:205–213 2003

14.

Waxman SG: Correlative Neuroanatomyed 24. New York: McGraw-Hill2000 p 216Waxman SG: Correlative Neuroanatomy ed 24. New York: McGraw-Hill 2000 p 216

15.

Wilson SAK: Ectopia pupilliae in certain mesencephalic lesions. Brain 29:5245361906Wilson SAK: Ectopia pupilliae in certain mesencephalic lesions. Brain 29:524–536 1906

TrendMD

Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 86 86 28
Full Text Views 83 83 11
PDF Downloads 115 115 9
EPUB Downloads 0 0 0

PubMed

Google Scholar