Ipsilateral pupil dilation associated with unilateral intermittent exotropia: a new observation

Dunlop, Catherine

doi:10.1111/j.1442-9071.2011.02659.x

Cited by 6 publications

(4 citation statements)

References 5 publications

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“…Dulop reported that there was abnormal pupil dynamic in patients with IXT; about onethird of patients with IXT have paradoxical pupil changes, and in these patients, pupil dilation occurs when the eyes are aligned immediately prior to exotropia. 12 However, our study revealed that pupil dynamics, pupil size, and response to light stimulation were within normal ranges. In addition, there was no signi cant association between pupil dynamics and the presence of TEC, or photosensitivity.…”

Section: Resultsmentioning

confidence: 52%

Investigation of Transient Eye Closure associated with Bright light in the Patients with Intermittent Exotropia

Choi

Jang

Kim

et al. 2021

Preprint

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Background: To present a simple method to evaluate transient eye closure (TEC) under bright light using binocular pupillometry in children with intermittent exotropia (IXT). Methods: Sixty-one children with IXT were studied using binocular pupillometry. Each patient was exposed to each phase as follows: scotopic phase (darkness) for 3,300 ms, mesopic phase for 200 ms, scotopic phase for 3,300 ms, low-intensity white light phase (10 cd/m2) for 200 ms, scotopic phase for 3,300 ms, and high-intensity white light phase (100 cd/m2) for 200 ms. TEC was present if the subject closed eyes immediately more than half in response to light, compared with the one in the scotopic phase. We assessed the agreement between TEC and self-reporting photosensitivity, and also evaluated the associated factors for the presence of TEC in IXT patients.Results: With the new method to evaluate TEC under different light intensities, 27 (44.3%) of the 61 IXT patients showed TEC, and 34 (55.7%) did not demonstrate TEC. TEC under high-intensity white light had a strong correlation with photosensitivity (r = 0.77). The smaller angle of deviation at near was associated with the presence of TEC, with statistical significance (p = 0.04). Normal sensory status at distance was significantly associated with TEC (p < 0.01). Multivariate analysis using multiple logistic regression analysis showed that normal sensory status was significantly associated with TEC (p = 0.02).Conclusions: The test using binocular pupillometry is useful in identifying TEC related to bright light, and the presence of TEC was strongly correlated with photosensitivity in patients with IXT.

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Section: Resultsmentioning

confidence: 52%

Investigation of Transient Eye Closure associated with Bright light in the Patients with Intermittent Exotropia

Choi

Jang

Kim

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…The iris is the primary organs controlling retinal luminance, and abnormal pupil dynamics may cause photosensitivity. Dulop reported that there was abnormal pupil dynamic in patients with IXT; about one-third of patients with IXT have paradoxical pupil changes, and in these patients, pupil dilation occurs when the eyes are aligned immediately prior to exotropia [ 14 ]. However, our study revealed that pupil dynamics, pupil size, and response to light stimulation were within normal ranges.…”

Section: Discussionmentioning

confidence: 99%

Investigation of transient eye closure evoked with bright light in the patients with intermittent exotropia

et al. 2021

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Background This study aimed to present a simple method for evaluating transient eye closure (TEC) evoked by bright light and find the agreement between TEC and photosensitivity. We also assessed the associated factors with TEC in the patients with intermittent exotropia (IXT). Methods In this retrospective study, IXT patients were exposed to different brightness: darkness, low-intensity white light, and high-intensity white light using a near-infrared camera vision monitor system (Mon CV3, Metrovision, France). TEC was considered to be present if the subject closed his or her eyes immediately, and for more than half of the scotopic lid fissure distance in response to the high-intensity or low-intensity photopic stimulus of light, compared with lid fissure distance in the scotopic phase. We assessed the presence of photosensitivity using a questionnaire and evaluated the agreement between TEC and photosensitivity. We also investigated the sensory fusion, motor fusion, and pupil dynamic components for the existence of TEC in IXT patients. Results Sixty-one patients with IXT were included. With the new method to evaluate TEC under different light intensities, 27 (44.3%) of the 61 IXT patients showed TEC, and 34 (55.7%) did not demonstrate TEC. TEC under high-intensity white light had a strong correlation with self-reporting photosensitivity (r = 0.77). The smaller angle of deviation at near was associated with the presence of TEC, with statistical significance (p = 0.04). Normal sensory status at a distance was significantly associated with TEC (p < 0.01). Multivariate analysis using multiple logistic regression analysis showed that normal sensory status was significantly associated with TEC (p = 0.02). Conclusions The test using a near-infrared camera vision monitor system was a simple and objective tool in identifying TEC evoked by bright light. The presence of TEC strongly correlated with self-reporting photosensitivity in patients with IXT. However, TEC may be an independent phenomenon with motor alignment, stereopsis, and pupil reflex pathway in patients with IXT.

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“…Pupillary dilation during exotropic episodes could be related to the retinal ganglion cell (RGC) pathway containing melanopsin, which mediates sustained constriction of the pupil in bright light. 17 Seizures can also commonly affect the pupil in various ways. Symptomatic pupillary hippus during seizure was reported by Centeno et al 18 No other autonomic-mediated responses were involved.…”

Section: Other Unusual Pupil Findingsmentioning

confidence: 99%

Neuro-ophthalmology Annual Review

Al‐Zubidi¹,

Spitze²,

Yalamanchili³

et al. 2013

Asia-Pacific Journal of Ophthalmology

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Ipsilateral pupil dilation associated with unilateral intermittent exotropia: a new observation

Cited by 6 publications

References 5 publications

Investigation of Transient Eye Closure associated with Bright light in the Patients with Intermittent Exotropia

Investigation of Transient Eye Closure associated with Bright light in the Patients with Intermittent Exotropia

Investigation of transient eye closure evoked with bright light in the patients with intermittent exotropia

Neuro-ophthalmology Annual Review

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