Pupillary reflex dynamics studied with infrared pupillography

: With a modified method of infrared pupillography--especially developed for the use in clinical neurological routine diagnosis--the time course of the direct phasic pupillary light reflex in man was investigated under physiological and pathological conditions. The described method allows a high resolution of the time course of the light reflex and is superior to kinematographic as well as video-methods described so far. Normally the physiological time parameters are bilaterally symmetrical, also in cases of so-called physiological anisocoria. On the other hand in pathological anisocorias of various etiology pronounced side-differences and abnormal time parameters can be found. Also in cases of isocoria with clinically no abnormal findings of pupillomotor response pathological side-differences can be determined by infrared pupillography. Disturbances of the afferent arc, of the efferent arc and of combination of those as well as pupillary abnormalities to be located in the midbrain area, can be exactly analyzed and documented. Furthermore the method allows an objective documentation of the course in cases of dysfunction of the autonomic nervous system, like in intoxications, or to monitor drug-induced therapeutical measurements. The investigations and findings indicate that infrared pupillography, an objective method for analyzing the dynamics of the pupillary light reflex, is suitable for clinical neurological routing diagnosis.