Introduction of a new, portable pc driven pupillometer with comparison of pupillography with the clinical RAPD

Purpose: To introduce and test a portable, binocular, desktop, PC driven, infrared pupillometer as a candidate diagnostic lest for the detection of afferent pupillary defects. Methods: Direct and consensual pupillary response curves were recorded in forty normal and twenty abnormal (clinical diagnosis of optic neuropathy and APD) patients on a new pupillometer supplied by Fairville Medical Optics. Full field green diode tight stimuli of 200 milliseconds duration ( 130 Candelas/m) were used and response curves were averaged for direct and consensual pupillary responses. We compared several parameters including: time to minimum pupil size, reflex amplitude (maximum change in pupil size), the velocity of constriction (ram/sec.) and the area to minimum pupil size between the two eyes of each patient. Data collected to date for each parameter in normal eyes and eyes with APD were analyzed with t-test and student t test. Results: Pupillary response curves were reproducible with the linear regression of the constriction phase of the response curves at greater than .96 in all cases. Some variability of response curves resulted from initial anisocoria. At the time of final data analysis the most reliable parameter which predicts normal versus abnormal pupillary reaction will be determined as well as parameters which demonstrate the reproducibility of the pupillography. Conclusions: 1) This new pupillometer is a reliable, convenient and portable method for recording pupillary response curves after both direct and consensual stimulation. 2) Various features of the pupillary response curve can be used to compare eyes and detect afferent pupil defects.