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Does EyeKinetix pupillometry clarify RAPD detection?

Mark A Kahrhoff1,2, Carl J Bassi3

  • 1Department of Ophthalmology, Washington University, St. Louis, MO, USA. kmark@wustl.edu.

Documenta Ophthalmologica. Advances in Ophthalmology
|April 1, 2026
PubMed
Summary
This summary is machine-generated.

Objective pupillometry using the EyeKinetix device shows significant variability in healthy individuals. This suggests that relying solely on relative afferent pupil defect (RAPD) scores may lead to false positives in screenings.

Keywords:
Automated pupillometryObjective pupillometryRelative afferent pupillary defect (RAPD), testing reliability, Marcus Gunn pupilSwinging flashlight test

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Area of Science:

  • Ophthalmology
  • Neuroscience
  • Medical Devices

Background:

  • Pupil light response (PLR) is a key indicator of optic nerve and retinal health.
  • Objective pupillometry offers a standardized method for assessing PLR.
  • Variability in PLR measurements can impact diagnostic accuracy.

Purpose of the Study:

  • To evaluate the variability of pupil light response measurements obtained with the EyeKinetix pupillometer.
  • To assess the repeatability and reliability of EyeKinetix measurements in healthy, non-dark-adapted individuals.

Main Methods:

  • Objective pupillometry was performed on 440 healthy individuals using the EyeKinetix device.
  • Key metrics included RAPDx amplitude and latency scores, and quantitative pupil dynamics.
  • Repeatability was analyzed using sequential retesting and statistical methods like ICC.

Main Results:

  • Significant variability was observed in both amplitude and latency scores.
  • Latency scores demonstrated low reliability (ICC = 0.165).
  • Amplitude, constriction velocity, and release velocity showed moderate to high reliability (ICC = 0.472-0.966).

Conclusions:

  • Objective pupillometry without dark adaptation using EyeKinetix reveals considerable variability in healthy subjects.
  • The findings suggest that sole reliance on RAPDx scores may result in false positives.
  • Further research is needed to establish normative cutoffs and validate the device in disease cohorts for reliable screening.