Would automated pupillometry be a useful addition when assessing acute vision loss?
Reviewed by Lauren Hepworth

The authors present a two-part study, the first part being an electronic survey of ophthalmologists and optometrists to identify barriers to the routine clinical use of automated pupillometry and the second, a clinical study comparing the swinging light tests and automated pupillometry. Clinical scenario vignettes were used as part of the electronic survey. One hundred and eight-one clinicians responded to the survey; the majority were optometrists. Twenty-one patients whose blurred vision was not corrected by updated refraction were included in the clinical study. The survey results report that a relative afferent pupillary defect (RAPD) remains a clinical finding which clinicians will act upon. The automated pupillary result presented in the vignettes resulted in more consistent next step responses than the swinging light test result. A false negative rate of 50% is reported from the clinical study when using the swinging light test. The authors discuss a number of factor which may be influencing the routine uptake of automated pupillometry. Limitations of this study including small sample size and limited geographical area are acknowledged. The authors also outline some future research which is required. This study highlights some of the potential benefits of using automated pupillometry. It may be that the correct setting for its routine use has not been identified.

Automated pupillometry as an adjunct to clinical examination in patients with acute vision loss.
Bhatnager R, Bimbaum AD, Baqai J, Volpe NJ.
JOURNAL OF NEURO-OPHTHALMOLOGY
2021;41:239-45.