J Korean Ophthalmol Soc.  2015 Jun;56(6):863-867. 10.3341/jkos.2015.56.6.863.

Comparison of Automatic Pupillometer and Pupil Card for Measuring Pupil Size

• Lee TJ
• Kim HS
• Jung JW
• Lee H
• Seo KY
• Lee HK
• Kim EK
• Kim TI

• KMID: 2339150
• DOI: http://doi.org/10.3341/jkos.2015.56.6.863

Abstract

PURPOSE
To compare the pupil sizes measured using the automatic pupillometer and pupil card.
METHODS
We measured pupil sizes using a pupil card (Rosenbaum Card, J.G. Rosenbaum, Cleveland, OH, USA) and automated pupillometer (VIP(TM)-200, Neuroptics Inc., San Clemente, CA, USA) under different luminous intensities in 60 eyes of 60 patients who visited the ophthalmology clinic during August 2013.
RESULTS
Under the photopic condition, pupil sizes measured using automated pupillometer were larger than those measured using the pupil card with statistical significance. The 2 techniques were not different under mesopic and scotopic conditions. Under all light conditions, automated pupillometer showed higher inter-rater reliability. Under the scotopic condition, pupil sizes measured using the pupil card were smaller than pupil sizes measured using the pupillometer according to increased pupil size.
CONCLUSIONS
When compared with pupil card, automated pupillometer provided accurate and reliable measurement with small inter-rater variation and was easy and simple to use. However, based on comparable measurements of both techniques under mesopic and scotopic conditions, the pupil card can be used as preoperative evaluation when considering the cost of purchase and maintenance.

Keyword

Pupil card; Pupillometer; Pupil size

MeSH Terms

Humans
Ophthalmology
Pupil*

Figure

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  Figure 1. Bland-Altman analysis of two different techniques. (A) Photopic. (B) Mesopic. (C) Scotopic (r＝ Pearson’s correlation coefficient, p＝ p-value).

Reference

References

1. Brunette I, Gresset J, Boivin JF, et al. Functional outcome and satisfaction after photorefractive keratectomy. Part 1: development and validation of a survey questionnaire. Ophthalmology. 2000; 107:1783–9.

2. Bailey MD, Mitchell GL, Dhaliwal DK, et al. Patient satisfaction and visual symptoms after laser in situ keratomileusis. Ophthalmology. 2003; 110:1371–8.

3. McGhee CN, Craig JP, Sachdev N, et al. Functional, psychological, and satisfaction outcomes of laser in situ keratomileusis for high myopia. J Cataract Refract Surg. 2000; 26:497–509.

4. Fan-Paul NI, Li J, Miller JS, Florakis GJ. Night vision disturbances after corneal refractive surgery. Surv Ophthalmol. 2002; 47:533–46.

5. Hammond SD Jr, Puri AK, Ambati BK. Quality of vision and patient satisfaction after LASIK. Curr Opin Ophthalmol. 2004; 15:328–32.

6. Endl MJ, Martinez CE, Klyce SD, et al. Effect of larger ablation zone and transition zone on corneal optical aberrations after photorefractive keratectomy. Arch Ophthalmol. 2001; 119:1159–64.

7. Martínez CE, Applegate RA, Klyce SD, et al. Effect of pupillary dilation on corneal optical aberrations after photorefractive keratectomy. Arch Ophthalmol. 1998; 116:1053–62.

8. Roberts CW, Koester CJ. Optical zone diameters for photorefractive corneal surgery. Invest Ophthalmol Vis Sci. 1993; 34:2275–81.

9. Charles KC. Screening for pupil size in prospective refractive surgery patients. J Cataract Refract Surg. 1998; 24:294.

10. Han J, Han KE, Ahn JM, et al. Influence of pupil size on visual acuity after implantation of the TECNIS 1-piece intraocular lens. J Korean Ophthalmol Soc. 2012; 53:1615–20.

11. Alarcón A, Rubiño M, Pééérez-Ocón F, Jiménez JR. Theoretical analysis of the effect of pupil size, initial myopic level, and optical zone on quality of vision after corneal refractive surgery. J Refract Surg. 2012; 28:901–6.

12. Lim DH, Lyu IJ, Choi SH, et al. Risk factors associated with night vision disturbances after phakic intraocular lens implantation. Am J Ophthalmol. 2014; 157:135–41.e1.

13. Helgesen A, Hjortdal J, Ehlers N. Pupil size and night vision disturbances after LASIK for myopia. Acta Ophthalmol Scand. 2004; 82:454–60.

14. Baek JS, Park JH, Yoo ES, et al. Comparison of Colvardpupillometer, ORBScan II and Sirius in determining pupil size for refractive surgery. J Korean Ophthalmol Soc. 2013; 54:1175–9.

15. Schallhorn SC, Kaupp SE, Tanzer DJ, et al. Pupil size and quality of vision after LASIK. Ophthalmology. 2003; 110:1606–14.

16. Chan A, Manche EE. Effect of preoperative pupil size on quality of vision after wavefront-guided LASIK. Ophthalmology. 2011; 118:736–41.

17. Myung D, Schallhorn S, Manche EE. Pupil size and LASIK: a review. J Refract Surg. 2013; 29:734–41.

18. Pop M, Payette Y. Risk factors for night vision complaints after LASIK for myopia. Ophthalmology. 2004; 111:3–10.

19. Schallhorn S, Brown M, Venter J, et al. The role of the mesopic pupil on patient-reported outcomes in young patients with myopia 1 month after wavefront-guided LASIK. J Refract Surg. 2014; 30:159–65.

20. Plainis S, Ntzilepis G, Atchison DA, Charman WN. Through-focus performance with multifocal contact lenses: effect of binocularity, pupil diameter and inherent ocular aberrations. Ophthalmic Physiol Opt. 2013; 33:42–50.

21. Artigas JM, Menezo JL, Peris C, et al. Image quality with multifocal intraocular lenses and the effect of pupil size: comparison of refractive and hybrid refractive-diffractive designs. J Cataract Refract Surg. 2007; 33:2111–7.

22. Salati C, Salvetat ML, Zeppieri M, Brusini P. Pupil size influence on the intraocular performance of the multifocal AMO-Array intraocular lens in elderly patients. Eur J Ophthalmol. 2007; 17:571–8.

23. Tomita M, Kanamori T, Waring GO 4th, Huseynova T. Retrospective evaluation of the influence of pupil size on visual acuity after KAMRA inlay implantation. J Refract Surg. 2014; 30:448–53.

24. Ho LY, Harvey TM, Scherer J, et al. Comparison of Rosenbaum pupillometry card using red and blue light to Colvard and Iowa pupillometers. J Refract Surg. 2010; 26:498–504.

25. Boxer Wachler BS, Krueger RR. Agreement and repeatability of pupillometry using videokeratography and infrared devices. J Cataract Refract Surg. 2000; 26:35–40.

26. Schallenberg M, Bangre V, Steuhl KP, et al. Comparison of the Colvard, Procyon, and Neuroptics pupillometers for measuring pupil diameter under low ambient illumination. J Refract Surg. 2010; 26:134–43.

27. Ko BU, Ryu WY, Park WC. Pupil size in the normal Korean population according to age and illuminance. J Korean Ophthalmol Soc. 2011; 52:401–6.

28. Rosen ES, Gore CL, Taylor D, et al. Use of a digital infrared pupillometer to assess patient suitability for refractive surgery. J Cataract Refract Surg. 2002; 28:1433–8.

29. Michel AW, Kronberg BP, Narváez J, Zimmerman G. Comparison of 2 multiple-measurement infrared pupillometers to determine scotopic pupil diameter. J Cataract Refract Surg. 2006; 32:1926–31.