Pupillary alterations

Pupils may be isochoric (equal pupils) or anisochoric (unequal pupils).

Examination ofthe pupils can provide important information on visual function.

Pupil examination is objective (easily measurable) and requires little collaboration.
Pupil assessment should be based on knowledge of:

• Anatomy: sympathetic and parasympathetic pathways, iris sphincter muscle, pupil dilator muscle.
• Physiology: pupillary reactions.
• Examination techniques: examination in light and dark, reflexes to light and accommodation, and alternating illumination test.
• Tests with eye drops.