Pupilometer: The New Age Way of Pupillary Evaluation

The pupilometer is a new age way for doctors to perform a neuro exam. 

It is a simple yet effective device that doctors can use for easy pupillary response testing. The device has been designed to provide quick results with minimal effort and cost. Compared to other methods of pupil evaluation, physicians can use this device on patients with limited cooperation or knowledge about what needs to be done. 

It will not cause any discomfort or pain to them during the test.

What is a pupilometer?

A pupilometer is one of the modern neurological tools that measure the size of a patient’s pupils. 

The pupils actually control how much light enters the eye and let people see better in dark environments. When a doctor uses a pupilometer, it helps them evaluate the health of someone’s eyes and optic nerve, which carries optical information from the retina to the brain. Doctors use this test when they suspect the patient may have neurological conditions.

How accurate is the pupilometer?

The pupilometer can measure pupil size in real-time and is, therefore, a reliable method of measuring pupil size. 

The pupilometer is less invasive than manual assessment; you only need a few seconds of eye scan to get an accurate reading. This makes the test faster and easier for the patient and clinician. They don’t have to worry about manual examinations leading to potential damage to their eyes.

Pupil Examination Is a Benchmark of Care and Is Important to Patient Outcome

Pupilometry is one of the essential tools in neurology and neurocritical care. 

It allows doctors to evaluate the state of brain function, check for signs of increased intracranial pressure or herniation, and provide a measure of the NPi. Besides being a standard part of every neurological examination, pupilometry has also been an effective tool for predicting outcomes from traumatic brain injury (TBI).

Pupilometry can help doctors determine whether their patient is consciously based on pupil reactivity. 

Manual Pupil Assessment is Highly Subjective and Inaccurate.

A manual pupil assessment was once the standard of care in ophthalmology.

However, it’s highly subjective and often inaccurate. Manual assessment involves an ophthalmologist or nurse practitioner manually examining a patient’s eye to assess pupil size, shape, reaction to light, and symmetry between both eyes.

Pupilometry is a new way to measure pupil size that’s more accurate than manual assessment, more objective than manual assessment, and more consistent than a manual assessment—saving time for providers and patients alike.

The Use of Pupilometry in Neurocritical Care

1. TBI

Sudden, violent, and rapid acceleration or deceleration of the head causes traumatic brain injuries (TBIs).

TBIs can lead to various symptoms, including confusion, paralysis, loss of consciousness, and coma. Pupilometry is a non-invasive technique that can diagnose and manage TBI patients. It measures the diameter of the pupil in response to light stimuli.

2. Cerebral Edema and Increased ICP 

An increase in fluid within the brain characterizes cerebral edema.

Increased intracranial pressure (ICP) is the force exerted by the cerebrospinal fluid on the walls of a patient’s skull. It can be a medical condition symptom, such as trauma, infection, or a brain tumor. If left untreated, increased ICP may permanently damage the eyes.

Pupilometry measures changes in pupil size so that doctors can determine what type of treatment they should give based on how severe the condition is.

3. Status Epilepticus (SE)

Status epilepticus (SE) is a medical emergency that requires prompt treatment.

It can lead to permanent brain damage or death if left untreated. SE occurs when a seizure lasts longer than 5 minutes, or there are multiple seizures without full recovery of consciousness between them. Using pupilometry in SE is beneficial as it gives doctors an idea about the extent of brainstem involvement, which helps health professionals decide on the management plan.

4. Ischemic and Hemorrhagic Stroke

Ischemic and hemorrhagic strokes are two different brain injuries that can occur when a blood vessel in the brain ruptures.

A clot, which blocks blood from reaching the brain, usually causes an ischemic stroke. Hemorrhagic strokes occur when a blood vessel ruptures, causing bleeding into surrounding tissues. After an ischemic stroke, the pupil will react abnormally to light and show signs of asymmetry. Hemorrhagic strokes rarely cause any observable change.