The Pupil and Pupillary Reflexes

Examination of the pupils and the pupillary reactions is vital for the ophthalmic clinical practitioner. Starting from history taking and even including the settings of the examination room all play an important role in pupillary examination and interpretation. Pupillary light reflexes give valuable information about the intactness of the optic nerve. Slit lamp examination of the pupil for its size, shape and congenital anomalies is also essential. Anisocoria refers to a difference in the pupillary sizes which is an important neurophthalmic sign with several causes which have to be carefully evaluated and diagnosed. Unique pupillary phenomena, pupillary edge cycle time and other pupillary movements seen are also discussed in the chapter.