Pupillresponsen

Pupillresponsen, or the pupil response, describes how the pupil changes size and reactivity in response to light, distance, and cognitive or emotional factors. The most prominent component is the pupillary light reflex, a reflexive constriction when light increases and dilation in dim conditions. This reflex helps regulate the amount of light reaching the retina and protects it from damage.

The reflex arc involves several anatomical steps. Light detected by the retina sends signals through the optic nerve to the pretectal area of the midbrain, then to the Edinger-Westphal nucleus. Parasympathetic fibers travel with the oculomotor nerve to the ciliary ganglion, and from there to the sphincter pupillae, causing constriction. Sympathetic pathways originate in the hypothalamus, descend to the superior cervical ganglion, and innervate the dilator pupillae, causing dilation. The result is a direct pupil response (in the illuminated eye) and a consensual response (in the opposite eye).

Measurement of pupillresponsen can be clinical, via observation of direct and consensual light responses, or more precise through pupillometry, which uses infrared imaging to quantify baseline diameter, constriction amplitude, latency, and recovery. Pupillometry is used in research and clinical settings to assess autonomic function and cognitive load.

Clinical significance includes diagnosing neurological and ocular disorders. Abnormal responses may indicate optic nerve or retinal disease, brainstem lesions, or third-nerve (oculomotor) pathology. Anisocoria that is greater in bright light suggests parasympathetic impairment, while anisocoria more evident in darkness points to sympathetic dysfunction. Cognitive and emotional states can also modulate the pupil response, reflecting activity of the locus coeruleus and arousal systems.