This master's thesis addresses the influence of selected parameters on the outcome of dynamic pupillometry. The theoretical part discusses the parameters of the pupil and its response to various stimuli such as light, distance, sensory and psychological stimuli, as well as pharmacological factors. The physiological phenomenon known as hippus is described, which may result from fluctuations between the sympathetic and parasympathetic nervous systems. These two systems are components of the autonomic nervous system, which is further discussed in the thesis.
The thesis presents procedures for pupil assessment in an optometric setting. Additionally, retinal photoreceptors are listed and described, and the pupil's response after the cessation of a stimulus is explained.
Subsequent chapters focus on pupillometry as a diagnostic tool. The standard pupillary light reflex (sPLR), relative afferent pupillary defect, and parameters measured by advanced pupillometers—such as quantitative Pupillary Light Reflex (qPLR) and the Neurological Pupillary Index (NPI)—are discussed. Measurement methods in dynamic pupillometry are compared, and results in a healthy population are presented.
The following sections describe the impact of various diseases and conditions on the pupillary response. Changes observed in pupillometry in conditions such as Alzheimer’s disease, Parkinson’s disease, autism, multiple sclerosis, pain, and general anesthesia are presented. Various types of stimulation in pupillometry and the influence of testing conditions on the results are also discussed. The theoretical part concludes with a description of chromatic pupillometry.
As part of this thesis, pupillometric tests were conducted, considering three parameters that may affect the pupillary response: fixation distance, light intensity, and measurement angle. The methodology and analysis of results are presented in the research section.