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Pupillometry to Assess Auditory Sensation in Guinea Pigs
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Published on: January 6, 2023

Pupil abnormalities in selected autonomic neuropathies.

Fion D Bremner1, Stephen E Smith

  • 1Department of Neuro-ophthalmology, National Hospital for Neurology and Neurosurgery, London, United Kingdom.

Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society
|September 13, 2006
PubMed
Summary

Pupil examination reveals frequent autonomic nervous system deficits in various neuropathies like diabetes and Sjögren syndrome. However, pupil abnormalities are rare in multiple system atrophy, complicating diagnosis when both sympathetic and parasympathetic systems are affected.

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Area of Science:

  • Ophthalmology
  • Neurology
  • Autonomic Nervous System Research

Background:

  • The pupil's autonomic innervation is crucial for ocular function.
  • Pupil abnormalities are common indicators of generalized autonomic neuropathies.
  • Understanding pupil response aids in diagnosing autonomic dysfunction.

Purpose of the Study:

  • To review the prevalence of pupil abnormalities in various autonomic neuropathies.
  • To highlight the diagnostic challenges associated with pupil pharmacologic testing.
  • To differentiate pupil involvement across different dysautonomia conditions.

Main Methods:

  • Literature review of studies on autonomic neuropathies and pupil function.
  • Analysis of reported cases of sympathetic and parasympathetic deficits.
  • Evaluation of diagnostic methods for pupil abnormalities.

Main Results:

  • High prevalence of sympathetic and parasympathetic deficits observed in conditions including diabetes, amyloidosis, and Sjögren syndrome.
  • Pupil abnormalities are relatively scarce in multiple system atrophy.
  • Combined sympathetic and parasympathetic deficits present diagnostic difficulties.

Conclusions:

  • Pupil examination is a valuable tool for detecting autonomic innervation disturbances.
  • Autonomic neuropathies frequently manifest with pupil abnormalities, except in multiple system atrophy.
  • Accurate diagnosis requires careful interpretation of pupil tests, especially in complex cases.