Abstract
Neurological and neurosurgical diseases encompass a broad spectrum of conditions that may present with acute or chronic courses, benign or malignant characteristics, diverse clinical manifestations, and prolonged recovery periods. Various assessment approaches are available for the early diagnosis, treatment planning, and timely intervention of these diseases. Several scales and scoring systems are used in their evaluation. One such assessment method is the measurement of the pupil and pupillary light reflex, which provides information about the sympathetic and parasympathetic branches of the autonomic nervous system, offers guidance regarding various neural structures, and enables an inexpensive and simple evaluation of patients’ clinical course. In recent years, technological advancements have enabled the objective measurement of this reflex through portable infrared pupillometry devices, thereby aiming to minimize inter-observer variability. However, due to the high cost of such objective assessment tools, many healthcare institutions may be unable to include them in their inventory. Consequently, pupil evaluation using a light source and pupil gauge, performed by healthcare professionals, remains a simple and practical method. To reduce potential inconsistencies in the evaluation process, it is essential that healthcare personnel possess adequate knowledge and practical experience in pupil assessment. This article reviews and synthesizes the relevant literature on pupil evaluation.
Conclusion
Enhancing the awareness of healthcare personnel regarding pupil assessment is critically important for the early detection of neurological and systemic complications. To this end, planning both theoretical and practical training programs will facilitate the effective use of manual and automated methods. With appropriate educational support, healthcare professionals can attain the competence to detect even minimal changes in the pupils, thereby enabling timely and accurate interventions for patients.Recent studies have demonstrated that quantitative pupillometry is effective not only in the evaluation of neurological conditions in clinical practice, but also in various other fields such as intracranial pressure monitoring, prognostic prediction after cardiac arrest, management of traumatic brain injury,nociception monitoring under anesthesia, and the assessment of autonomic effects of metabolic disorders. Furthermore, digital pupillometry and artificial intelligence–assisted analysis systems hold the potential to provide highly accurate measurements even under variable environmental conditions.In this context, with the widespread adoption of advanced technologies and the reduction of costbarriers, pupillometry is expected to be used more extensively in early diagnosis, patient monitoring,and therapeutic applications. In the future, more comprehensive, large-scale, and prospective studies will be required on this subject. Such studies will play a crucial role in the standardization of measurement protocols and will provide guidance in clinical patient follow-up.
Sakarya University Journal of Holistic Health, 8(3) 2025, 190-201198References1. Bae KS, Roh YS. Training needs analysis of Korean nurses’ neurological assessment competency.Nurs Health Sci. 2020;22(1):99-107. doi:10.1111/nhs.126542.
(PDF) Pupil and Pupillary Light Reflex. Available from: https://www.researchgate.net/publication/399154048_Pupil_and_Pupillary_Light_Reflex
