Refractive Error May Influence Mesopic Pupil Size

Çakmak, Hasan Basri; Çağıl, Nurullah; Simavlı, Hüseyin; Duzen, Betul; Şimşek, Şaban

doi:10.3109/02713680903447892

Cited by 49 publications

(33 citation statements)

References 19 publications

(14 reference statements)

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“…The results from our study are in agreement with two earlier studies conducted on preoperative refractive surgery candidates 8,9. Cakmak et al and Linke et al reported significant differences in pupil size according to both age (smaller pupils with increasing age) and refractive error (smaller pupils in hyperopes than myopes); however, in their studies, measurements were only conducted under mesopic conditions, whereas our study was conducted at three luminance levels representing those commonly encountered during day-to-day activities.…”

Section: Discussionsupporting

confidence: 93%

“…More recently, the role of refractive status on pupil size has been investigated in several refractive surgery studies. Although no relationship was found in one study with a relatively small sample size,7 two larger studies of refractive surgery candidates reported that the preoperative refractive status was found to be a determinative factor in pupil size when measured under mesopic conditions, with smaller pupil sizes reported for hyperopes than myopes 8,9…”

mentioning

confidence: 94%

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The Effects of Age, Refractive Status, and Luminance on Pupil Size

et al. 2016

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PurposePupil size is critical for optimal performance of presbyopic contact lenses. Although the effect of luminance is well known, little information is available regarding other contributing factors such as aging and refractive status.MethodsThe cohort population comprised 304 patients (127 male, 177 female) aged 18 to 78 years. Pupils were photographed at three controlled luminance levels 250, 50, and 2.5 cd/m2 using an infra-red macro video camera. Measurements of pupil diameter were conducted after transforming pixel values to linear values in millimeters.ResultsLuminance was the most influential factor with pupil diameter increasing with decreased luminance (p < 0.001, all comparisons). Age was also found to be a significant factor with a smaller diameter in the older groups, but overall the difference was only significant between the pre-presbyopes and the established presbyopes (p = 0.017). Pupil diameter decreased significantly with increasing age, the effect being most marked at low luminance (<0.001). The smallest pupil diameters were measured for hyperopes and the largest for myopes and although refractive error was not a significant factor alone, there was a significant interaction between luminance and refractive error with the greatest differences in pupil diameter between myopes and emmetropes at low luminance (p < 0.001). Pupil diameter changes modeled by multilinear regression (p < 0.001) identified age, luminance, best sphere refraction, and refractive error as significant factors accounting for just over 70% of the average variation in pupil diameter.ConclusionsBoth age and refractive status were found to affect pupil size with larger pupils measured for younger patients and myopes. Designs for multifocal contact lens corrections should take both age and refractive status into consideration; a faster progression from distance to near corrections across the optical zone of the lens is expected to be required for established presbyopes and hyperopes than it is for early presbyopes, myopes, and emmetropes.

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Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 94%

The Effects of Age, Refractive Status, and Luminance on Pupil Size

et al. 2016

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“…Pupil size correlates with both the magnitude and orientation of astigmatism. Larger mesopic pupil sizes are detected with higher cylinder powers and are also associated with with-the-rule astigmatism rather than against-the-rule and oblique astigmatism (Cakmak et al, 2010). Larger pupil sizes-in low lighting conditions-increase the amount of higher order aberrations such as coma and may intensify the cylinder power in subjective/manifest refraction.…”

Section: Pupil Dynamicsmentioning

confidence: 95%

Physiology of Astigmatism

Mohammadi¹,

Tahvildari²,

Z-Mehrjardi³

2012

Astigmatism - Optics, Physiology and Management

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“…We thank the authors for bringing additional articles investigating the relationship between pupil diameter and refractive error to our attention [2][3][4][5] . These articles were not omitted as a result of an incomplete literature search, as suggested by Guillon et al; they were omitted from our citations because the methodology in these studies meant that they were not comparable to our study and therefore their inclusion would have been inappropriate.…”

mentioning

confidence: 99%

“…We also feel that it is unsatisfactory to cite conference abstracts in peer reviewed papers as the source data is not easily verifiable 5 . The data from all of the omitted studies [2][3][4][5] were collected under mesopic illumination conditions which, although relevant in the context of refractive surgery, are not comparable to our study in which we deliberately examined pupil diameter over a wide photopic illumination range. This is due to the fact that the influence of the accommodation response, which was central to our study, would not have been accurate in mesopic conditions and would have likely fallen to tonic resting levels.…”

mentioning

confidence: 99%