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Dilation and constriction of the pupil. Pupillary response is a physiological response that varies the size of the pupil, via the optic and oculomotor cranial nerve.. A constriction response (), [1] is the narrowing of the pupil, which may be caused by scleral buckles or drugs such as opiates/opioids or anti-hypertension medications.
Mydriasis is the dilation of the pupil, usually having a non-physiological cause, [3] or sometimes a physiological pupillary response. [4] Non-physiological causes of mydriasis include disease, trauma, or the use of certain types of drug. It may also be of unknown cause.
Nerves involved in the resizing of the pupil connect to the pretectal nucleus of the high midbrain, bypassing the lateral geniculate nucleus and the primary visual cortex. From the pretectal nucleus neurons send axons to neurons of the Edinger-Westphal nucleus whose visceromotor axons run along both the left and right oculomotor nerves .
Greater pupil dilation is associated with increased processing in the brain. [45] Vacchiano and colleagues (1968) found that pupillary responses were associated with visual exposure to words with high, neutral or low value. Presented low-value words were associated with dilation, and high-value words with constriction of a pupil. [46]
It explains the defining features of a tonic pupil: (1) The pupil does not react to light. The original light-reaction neurons have been destroyed. (2) Tonic constriction with attempted near vision. Aberrant regeneration of nerve fibers intended for the ciliary muscle causes abnormal, tonic contraction of the pupil with accommodation.
In the former, the ptosis occurs with a constricted pupil (due to a loss of sympathetics to the eye), whereas in the latter, the ptosis occurs with a dilated pupil (due to a loss of innervation to the sphincter pupillae). In a clinical setting, these two ptoses are fairly easy to distinguish.
Whereas, the pupil is the passive opening formed by the active iris. Pupillary reflex is synonymous with pupillary response, which may be pupillary constriction or dilation. Pupillary reflex is conceptually linked to the side (left or right) of the reacting pupil, and not to the side from which light stimulation originates.
If the drug pilocarpine is administered, the pupils will constrict and accommodation is increased due to the parasympathetic action on the circular muscle fibers, conversely, atropine will cause paralysis of accommodation (cycloplegia) and dilation of the pupil. Certain drugs cause constriction of the pupils, such as opioids. [7]