Clinically, abnormal pupil size and responsivity provide important clues to detect the site and nature of various lesions along its extensive afferent and efferent pathways. The pupils are routinely studied by clinicians to assess, in part, the neural integrity of the visual system. However, the visual dysfunction relevant to the present review is that of the pupillary light reflex (PLR). More specifically, it may produce a constellation of visual problems of a sensory (e.g., reduced contrast sensitivity, visual field deficits), motor (e.g., vergence dysfunction, saccadic dysmetria) and/or perceptual (e.g., impaired distance perception, difficulty with figure–ground discrimination) nature. For example, there may be problems with impulse control, sleep, attention and memory, to name a few. In addition, this pervasive brain injury results in a constellation of general medical problems of a sensory, motor, perceptual, cognitive, attentional, physical, physiological and/or behavioral nature. This is especially the case for the white matter tracts, which become stretched/deformed and at times broken leading to neural signal processing errors, distortions and delays. The resultant injury to the brain and surrounding microenvironment, frequently being of a coup–contrecoup nature, produces widespread neural damage. There are approximately 1.8 million mTBIs in the USA annually, primarily from motor vehicle accidents, falls and sports/recreational accidents, with perhaps up to 10 million worldwide. This was primarily as a result of the USA’s recent military encounters in Iraq and Afghanistan, where TBI was the ‘signature injury’ and frequently the ‘invisible injury’, as well as from the sports arena, in particular football with its potential link to chronic traumatic encephalopathy. The area of mTBI has been in the forefront of the medical world for more than a decade. The pupil may also be a window to mild traumatic brain injury (mTBI). Some believe that the pupil is the window to the soul. Pupil size normal and assessment should be done to check your overall health and condition.First draft submitted: 14 December 2016 Accepted for publication: 15 February 2017 Published online: 3 August 2017 it is important for you to have a pupil with a size between 2.0 mm and 5.0 mm. If there is any interruption or abnormalities on the pathway, it is a sign of a disease that should be checked in more detailed test.Īs you can see, there are several types of pupil reaction which reveal a disease you are having. Bottom part of subclavian artery is the next destination of the pupil nerve, then it goes to the neck and the extension of brain, reaching its final destination near the optic nerve and straight to perrla pupil. It starts from the brain, continuing down to the spinal cord and then back up over the top of the lung. Long nerve pathway controlled how the pupil reacts. When you do an eye assessment, any differences or abnormalities on the pupil are noted. You should know that younger people tend to have bigger pupil compared to adult or elderly. A dilated pupil should be around the size of 5.0 mm while a constricted pupil should be around the size of 2.0 mm. There is a specific number that determine whether your pupil is normal or no. The muscles on your iris will control the amount of light that will be received by the retina. Pupil will expand (dilate) when the amount of light is low and become smaller (constrict) if the exposure to light is quite high. It controls the amount of light received by your eyes. See also The Six Cardinal Fields Of Gaze The precise measurement of a pupil: Normal pupil size mmĬamera aperture is the perfect analogy to see how your pupil works. Argyll-Robertson pupil will react abnormally to light and will constrict on near focusing. Syphilis has a possibility to make your pupil into an Argyll-Robertson pupil, which is small, misshapen, and unequal pupil. Stroke may change the size of your pupil and cluster headaches can make your pupil constricted. Be careful that certain drugs and medication may affect your The Pupillary: Pupil Size Normal and Assessment. A tumor that located near the pupillary nerve fibers may cause problems to the pupil. Cancer on the top of your lung will affect the pupillary nerve fibers. Aneurysm may dilate your pupil if it pushes certain blood vessels on your brain. Mid-dilated pupil will be seen to those who suffer from glaucoma.
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