Segmental Light Reflex Movements of the Pupil During Contraction and Dilation

Segmental palsies of the pupil sphincter can be observed with the slit lamp exam in post-ganglionic parasympathetic lesions such as Adie pupil. Segmental palsies of the dilator muscle have not been studied, but irregular, out of round pupils can sometimes be observed during dilation in oculosympathetic lesions. Asynchronous movement of the pupil during contraction and dilation may be an important diagnostic feature parasympathetic and sympathetic lesions. Our purpose was to quantify asynchronous iris movements in normal and abnormal pupils. We hypothesized that autonomic nerve deficits cause asynchronous reflex contractions and dilation and maybe useful in diagnosis and localization.