SUMMARY1. To study the relationship between accommodation under natural viewing conditions, age and refractive errors, we have measured time courses of accommodation in thirty-nine human subjects aged 5-49 years using a newly developed technique. The technique is based on infrared photoretinoscopy and involves fully automated on-line image processing of digitized video images of the eyes with a sampling rate of 5 3 Hz.2. The distance between the subject and the video camera was about 13 m. Head movements of the subject required little restriction because the eyes were automatically tracked in the video image by the computer program. All subjects were tested under binocular viewing conditions. 3. Both refraction of the right eye and pupil diameter were measured with a precision of 0-2-0{4 dioptres (D) and 041 mm, respectively, and were plotted on-line. The data were subsequently automatically analysed. 4. Automated infrared photoretinoscopy proved to be very convenient and easy to handle in both children and adults.5. The maximal speed of accommodation for a target at a distance of 5 D declined in the subjects with age (from up to 2P7 ID s-' for accommodation and 32 7 D s-' for subsequent accommodation to a distant target ('near to far accommodation') in children down to 2-18 D s-' in adults). There was a striking inter-individual variability in the maximum possible speed of accommodation and near to far accommodation.6. Speed of accommodation and of near to far accommodation was correlated for each subject. However, in most of the subjects, the process of near to far accommodation was faster than accommodation (P < 0005, if averaged over all subjects). This correlation was independent of age.7. The accommodation-induced pupillary constriction (pupillary near response) was absent in children for a 4 D target; even at 10 D, there was no reliable pupillary response. The pupillary near response increased to about tP6 mm D-of accommodation at the age of 47. Since a pupillary near response could still be elicited MUS 1:313

The number of research groups studying the pupil is increasing, as is the number of publications. Consequently, new standards in pupillography are needed to formalize the methodology including recording conditions, stimulus characteristics, as well as suitable parameters of evaluation. Since the description of intrinsically photosensitive retinal ganglion cells (ipRGCs) there has been an increased interest and broader application of pupillography in ophthalmology as well as other fields including psychology and chronobiology. Color pupillography plays an important role not only in research but also in clinical observational and therapy studies like gene therapy of hereditary retinal degenerations and psychopathology. Stimuli can vary in size, brightness, duration, and wavelength. Stimulus paradigms determine whether rhodopsin-driven rod responses, opsin-driven cone responses, or melanopsin-driven ipRGC responses are primarily elicited. Background illumination, adaptation state, and instruction for the participants will furthermore influence the results. This standard recommends a minimum set of variables to be used for pupillography and specified in the publication methodologies. Initiated at the 32nd International Pupil Colloquium 2017 in Morges, Switzerland, the aim of this manuscript is to outline standards in pupillography based on current knowledge and experience of pupil experts in order to achieve greater comparability of pupillographic studies. Such standards will particularly facilitate the proper application of pupillography by researchers new to the field. First we describe general standards, followed by specific suggestions concerning the demands of different targets of pupil research: the afferent and efferent reflex arc, pharmacology, psychology, sleepiness-related research and animal studies.

The PowerRefractor was shown to have comparable or slightly better reliability and accuracy than a modern autorefractor; however, it has major advantages over current autorefractors in that it is faster, measures both eyes at once, and gives interpupillary distance, pupil size, and information on the alignment of the eyes at the same time.

Spontaneous pupillary behaviour in darkness provides information about a subject's level of vigilance. To establish infrared video pupillography (IVP) as a reliable and objective test in the detection and quantification of daytime sleepiness, the definition of numerical parameters is an important precondition characterising spontaneous pupil behaviour adequately for further statistical procedures. The correct measurement of the pupil size, even if the lid or eyelashes are occluding the pupil, is of particular concern when testing vigilance. In this case many edge points of the pupil are detected and a fitting procedure is described that fits these edge points to a circle and excludes outliers. The first step of data preparation consists of a mathematical artefact management consisting of blink detection and elimination, followed by interpolation. Second, a fast Fourier transformation is carried out for frequencies from 0.0 to 0.8 Hz for each time segment of 82 s. Results are given in absolute and relative power of each frequency band per time segment and mean values over the entire record of 11 min. Third, the changes of the mean pupillary diameter per data window against time are shown graphically. An additional parameter referring to the pupil's tendency to instability, the pupillary unrest index (PUI), is defined by cumulative changes in pupil size based on mean values of consecutive data sequences. These mathematical procedures provide a high level of quality in both data collection and evaluation of IVP as an objective test of vigilance. In a pilot study, the pupillary behaviour of two groups were measured. One group rated themselves as alert (ten men), the other group as sleepy (12 men). The power and PUI were compared using the Mann-Whitney U-test. Both parameters show significant differences between the two groups.

ABSTRACT.Toxic optic neuropathy (TON) is caused by the damage to the optic nerve through different toxins, including drugs, metals, organic solvents, methanol and carbon dioxide. A similar clinical picture may also be caused by nutritional deficits, including B vitamins, folic acid and proteins with sulphur-containing amino acids. This review summarizes the present knowledge on disease-causing factors, clinical presentation, diagnostics and treatment in TON. It discusses in detail known and hypothesized relations between drugs, including tuberculostatic drugs, antimicrobial agents, antiepileptic drugs, antiarrhythmic drugs, disulfiram, halogenated hydroquinolones, antimetabolites, tamoxifen and phosphodiesterase type 5 inhibitors and optic neuropathy.Key words: adalimumab optic neuropathy -antitumor necrosis factor alpha optic neuropathycuban epidemic optic neuropathy -ethambutol optic neuropathy -infliximab optic neuropathy -Leber's hereditary optic neuropathy -nutritional optic neuropathy -tobaccoalcohol amblyopia -toxic optic neuropathy Acta Ophthalmol. 2015: 93: 402-410

Pupil size is regulated exclusively by the autonomic nervous system, and in darkness is proportional to the level of central sympathetic tone. Spontaneous pupillary movements, while at rest in darkness and quiet, were recorded for a period of 11 min, using infrared video pupillography. Thirteen young adults took part in a 30‐h experiment lasting from 08.00 h to 14.00 h on the following day. Pupillographic testing and completion of a self‐rated scale for the estimate of sleepiness were repeated every two hours. Pupillary unrest index (PUI), as a measure of pupil size instability associated with daytime sleepiness, showed the lowest values at 09.00 h, when pupil size was found to be maximal, and 23.00 h. During the course of the day, amplitude spectrum ≤0.8 Hz and PUI showed increasing values during the afternoon hours, followed by a decrease during the evening. Daytime variations in the pupillary unrest index in healthy normal subjects were found to be positively correlated with the level of alertness. These findings are similar to the daytime variations found by the MSLT (multiple sleep latency test) in young adults.

Optic neuritis is easy to distinguish from otherv diseases affecting the optic nerve. Atypical forms of this disease and other optic nerve diseases require special treatment. For patients judged to be at high risk of developing multiple sclerosis, immune prophylaxis with beta- interferon or glatiramer acetate is recommended.

The development of personal computer-based infrared video instruments has allowed pupillography to enter the clinical arena. Measuring pupil diameter for refractive surgery, distinguishing Horner syndrome from physiologic anisocoria, quantifying the relative afferent pupillary defect, and plotting visual fields by means of graded pupil constriction to focal light stimuli are recent applications in ophthalmology. Pupillography has also been used to determine sleepiness and autonomic effects of new pharmaceuticals.