Factors influencing the pupillary light reflex in healthy individuals

Sourabh Sharma, Mani Baskaran, Annadata Venkata Rukmini, Monisha E. Nongpiur, Hla Myint Htoon, Ching-Yu Cheng, Shamira A. Perera, Joshua J. Gooley, Tin Aung, Dan Milea

Research output: Contribution to journalArticleResearchpeer-review

28 Citations (Scopus)


Purpose: To determine the ocular anatomical factors influencing the pupillary light reactions to different wavelengths of light, measured with chromatic pupillometry. Methods: Community-based, cross-sectional study including subjects with normal ocular health (ages 50–79 years). Direct pupillary responses to continuously increasing irradiances (6.8 to 13.8 log photons cm−2 s−1) of red (631 nm) and blue (469 nm) light were measured, using a dedicated infrared pupillometer. All subjects underwent swept source optical coherence tomography (SS-OCT, CASIA SS-1000, Tomey Corporation, Nagoya, Japan) and noncontact partial coherence laser interferometry (Lenstar LS900, Haag-Streit AG, Switzerland). Univariate and multivariable regression analyses were performed to determine the anatomical features influencing pupillographic parameters. Results: Among the 177 included subjects, 167 (94.4 %) were Chinese and 116 (65.5 %) female. The average baseline pupil diameter in darkness (β = −0.080, p < 0.001) and the amplitude of the relative pupillary constriction (β = −0.233, p = 0.006) to blue light decreased with age. The amplitude of pupillary constriction was significantly larger in patients with a thinner iris, in response to stimulation with blue (β = −0.321, p < 0.001) and red light (β = −0.336, p < 0.001). Other ocular parameters (i.e., lens vault, anterior chamber depth width, iris volume, iris curvature, and lens thickness) were not significantly associated with pupillometric outcomes. Conclusions: The amplitude of the pupillary light constriction to chromatic photic stimuli is reduced with increasing age and iris thickness in subjects with normal ocular health, a finding which needs to be integrated into future pupillometric studies.

Original languageEnglish
Pages (from-to)1353-1359
Number of pages7
JournalGraefes Archive for Clinical and Experimental Ophthalmology
Issue number7
Publication statusPublished - 1 Jul 2016
Externally publishedYes


  • Intrinsically photosensitive retinal ganglion cells
  • Iris thickness
  • Pupil
  • Pupillary light reflex
  • Pupillometry

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