B-mode ultrasound assessment of pupillary function: Feasibility, reliability and normal values

Felix A. Schmidt*, Klemens Ruprecht, Florian Connolly, Matthew B. Maas, Friedemann Paul, Jan Hoffmann, Lutz Harms, Stephan J. Schreiber

*Corresponding author for this work

Research output: Contribution to journalArticle

3 Scopus citations


Purpose: To evaluate B-mode ultrasound as a novel method for the examination of pupillary function and to provide normal values for the pupillary reflex as assessed by B-mode ultrasound. Methods: 100 subjects (49 female, 51 male, mean [range] age 51 [18–80 years]) with no history of ophthalmologic disease, no clinically detectable pupillary defects, and corrected visual acuity 0.8 were included in this prospective observational study. B-mode ultrasound was performed with the subjects eyes closed using an Esaote-Mylab25 system according to current guidelines for orbital insonation. A standardized light stimulus was applied. Results: The mean ± standard deviation left and right pupillary diameters (PD) at rest were 4.7 ± 0.8 and 4.5 ± 0.8 mm. Following an ipsilateral light stimulus (Lstim), left and right constricted PD were 2.8 ± 0.6 and 2.7 ± 0.6 mm. Following a contralateral Lstim, left and right constricted PD were 2.7 ± 0.6 and 2.6 ± 0.5 mm. Left and right pupillary constriction time (PCT) following ipsilateral Lstim were 970 ± 261.6 and 967 ± 220 ms. Left and right PCT following a contralateral Lstim were 993.8 ± 192.6 and 963 ± 189.4 ms. Patient age was inversely correlated with PD at rest and with PD after ipsilateral and contralateral Lstim (all p<0.001), but not with PCT. Conclusions: B-mode ultrasound is a simple, rapid and objective method for the quantitative assessment of pupillary function, which may prove useful in a variety of settings where eyelid retraction is impeded or an infrared pupillometry device is unavailable.

Original languageEnglish (US)
Article numbere0189016
JournalPloS one
Issue number12
StatePublished - Dec 2017

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Fingerprint Dive into the research topics of 'B-mode ultrasound assessment of pupillary function: Feasibility, reliability and normal values'. Together they form a unique fingerprint.

  • Cite this

    Schmidt, F. A., Ruprecht, K., Connolly, F., Maas, M. B., Paul, F., Hoffmann, J., Harms, L., & Schreiber, S. J. (2017). B-mode ultrasound assessment of pupillary function: Feasibility, reliability and normal values. PloS one, 12(12), [e0189016]. https://doi.org/10.1371/journal.pone.0189016