Normal Pupil Size and Anisocoria in Newborn Infants

Roarty, John D.; Keltner, John L.

doi:10.1001/archopht.1990.01070030100037

Cited by 26 publications

(10 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We were able to obtain CA images of the optic disc in children as young as 4 months of age without the use of pupillary dilation or eyelid specula. Pupillary dilation in adult subjects has improved perceived ease of use of the Pan Optic ophthalmoscope . It is possible that the use of papillary dilation and eyelid specula could have improved the rate of CA image acquisition in our study in children less than 2 years of age.…”

Section: Discussionmentioning

confidence: 83%

Nonmydriatic Fundoscopic Imaging Using the Pan Optic iExaminer System in the Pediatric Emergency Department

Day¹,

Wang

Huang³

2017

Academic Emergency Medicine

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 83%

Nonmydriatic Fundoscopic Imaging Using the Pan Optic iExaminer System in the Pediatric Emergency Department

Day¹,

Wang

Huang³

2017

Academic Emergency Medicine

View full text Add to dashboard Cite

show abstract

“…Adequate photography would also likely require pupillary dilation because of the typically small pupillary diameters of infants. 14 Furthermore, nonmydriatic photography is best suited to image conditions affecting the posterior pole, with a 45° field-of-view that extends to just beyond the vascular arcades. Thus this technology cannot alleviate the need for dilated funduscopic examinations and examinations under anesthesia in specific ophthalmology settings.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and quality of nonmydriatic fundus photography in children

Toffoli

Lamirel

Henderson

et al. 2011

Journal of American Association for Pediatric Ophthalmology and

View full text Add to dashboard Cite

Purpose Ocular funduscopic examination is difficult in young children and is rarely attempted by nonophthalmologists. Our objective was to determine the feasibility of reliably obtaining high-quality nonmydriatic fundus photographs in children. Methods Nonmydriatic fundus photographs were obtained in both eyes of children seen in a pediatric ophthalmology clinic. Ease of fundus photography was recorded on a 10-point Likert scale (10 = very easy). Quality was graded from 1 to 5 (1, inadequate for any diagnostic purpose; 2, unable to exclude all emergent findings; 3, only able to exclude emergent findings; 4, not ideal, but still able to exclude subtle findings; and 5, ideal quality). The primary outcome measure was image quality by age. Results A total of 878 photographs of 212 children (median age, 6 years; range,1-18 years) were included. Photographs of at least one eye were obtained in 190 children (89.6%) and in both eyes in 181 (85.3%). Median rating for ease of photography was 7. Photographs of some clinical value (grade ≥2) were obtained in 33% of children <3 years and 95% >3 years. High-quality photographs (grade 4 or 5) were obtained in both eyes in 7% of children <3 years, 57% of children ≥3 to <7 years, 85% of children ≥7 to <9 years, and 65% of children ≥9 years. The youngest patient with high-quality photographs in both eyes was 22 months. Conclusions Nonmydriatic fundus photographs of adequate quality can be obtained in children over age 3 and in some children as young as 22 months.

show abstract

“…All efforts were made to obtain pictures while the neonate was calm, generally while the infant was lying in a pram or being held by a nurse or parent. The same eye was photographed each time within individual neonates to control for anisocoria (i.e., unequal pupil sizes; Isenberg et al, 1989; Roarty and Keltner, 1990). …”

Section: Methodsmentioning

confidence: 99%

“…The camera’s image capture speed was much shorter than the minimum latent period of the pupillary light reflex (<10 milliseconds vs. 180 millisecond; Lowenfeld, 1999); thus, the flash did not alter the size of the pupil in the resulting image, but did make the boundaries of the pupil and iris on the resulting image crisper, facilitating measurement. Other studies measuring pupil diameter in infants, children, and adults have used this same procedure (MacLachlan and Howland, 2002; Roarty and Keltner, 1990; Twa et al, 2004). Every attempt was made to hold the camera on the same horizontal and vertical plane as the eye that was being photographed.…”

Section: Methodsmentioning

confidence: 99%

Infant pupillary response to methadone administration during treatment for neonatal abstinence syndrome: A feasibility study

Heil¹,

Gaalema²,

Johnston³

et al. 2012

Drug and Alcohol Dependence

View full text Add to dashboard Cite

Background Pupil diameter is a frequently assessed objective index of the pharmacodynamic effects of opioids in adults, but to our knowledge has never been examined in infants. Such a measure could improve assessment and treatment of neonates exposed to opioids in utero. The present study examined changes in pupil diameter after opioid administration in opioid-exposed infants who required pharmacological treatment for neonatal abstinence syndrome (NAS) to test the feasibility of using pupil diameter as a measure of opioid effects in these infants. Methods Ten infants (2–7 days old) receiving methadone (0.4–0.5 mg every 12 hours) for the treatment of NAS participated. A picture of one of each infant's eyes was taken under controlled illumination conditions with a standard digital camera just prior to dosing and 0–1, 2–4, 5–7, and 8–10 hours after dosing. The diameters of the pupil and iris were measured and relative pupil diameter (pupil diameter expressed as a percentage of iris diameter) was analyzed. Results Mean (±SE) relative pupil diameter decreased significantly after dosing from 41±2% to 29±2%. After dosing, a significant increasing linear trend was observed over time, with values of 29±2%, 33±3%, 38±3%, and 41±3% at 0–1, 2–4, 5–7, and 8–10 hours after dosing. Conclusions Infant pupils respond to opioid administration in the same sensitive, orderly manner as is commonly observed in adults. Pupil diameter appears to be an objective, sensitive measure of neonatal response to opioids that may be a useful complement to, or perhaps at times a replacement for, observer-rated scale scores.

show abstract

Normal Pupil Size and Anisocoria in Newborn Infants

Cited by 26 publications

References 16 publications

Nonmydriatic Fundoscopic Imaging Using the Pan Optic iExaminer System in the Pediatric Emergency Department

Nonmydriatic Fundoscopic Imaging Using the Pan Optic iExaminer System in the Pediatric Emergency Department

Feasibility and quality of nonmydriatic fundus photography in children

Infant pupillary response to methadone administration during treatment for neonatal abstinence syndrome: A feasibility study

Contact Info

Product

Resources

About