Journal article
Ophthalmology in the Blink of an Eye: The Light-Induced Eyelid Reflex
Journal of neuro-ophthalmology, Vol.45(2), pp.243-248
06/2025
DOI: 10.1097/WNO.0000000000002358
PMID: 40275454
Abstract
A video-based assessment of the light-induced eyelid reflex, termed the photic blink reflex (PBR), was quantified based on the degree of palpebral fissure (PF) narrowing as a noninvasive test of visual input. The physiology of PF narrowing in response to light intensity was compared to the pupil light reflex, measured simultaneously.BACKGROUNDA video-based assessment of the light-induced eyelid reflex, termed the photic blink reflex (PBR), was quantified based on the degree of palpebral fissure (PF) narrowing as a noninvasive test of visual input. The physiology of PF narrowing in response to light intensity was compared to the pupil light reflex, measured simultaneously.Eyelid and pupil responses to flashes of white light stimulus, increasing in intensity, were video recorded in 53 subjects using a monocular hand-held device. Responses to photopic red and blue light stimuli were recorded in 5 subjects. Percent-change of PF width and pupil width from the prestimulus baseline was measured.METHODSEyelid and pupil responses to flashes of white light stimulus, increasing in intensity, were video recorded in 53 subjects using a monocular hand-held device. Responses to photopic red and blue light stimuli were recorded in 5 subjects. Percent-change of PF width and pupil width from the prestimulus baseline was measured.In 81% of subjects, there was significant correlation between PF narrowing and light stimulus intensity. There was no correlation between the PBR and the pupil light reflex in the same eye in normal subjects. There was no sustained postillumination PF narrowing to bright blue-light stimuli compared to the postillumination sustained pupil response that was present in response to the same stimulus.RESULTSIn 81% of subjects, there was significant correlation between PF narrowing and light stimulus intensity. There was no correlation between the PBR and the pupil light reflex in the same eye in normal subjects. There was no sustained postillumination PF narrowing to bright blue-light stimuli compared to the postillumination sustained pupil response that was present in response to the same stimulus.The photic blink reflex can be quantified with video recording of the palpebral fissure. The photic blink reflex has potential utility as an alternative to the pupil light reflex in assessing asymmetric pathologies of the afferent visual pathway, especially in eyes with pharmacologically dilated or unreactive pupils.CONCLUSIONSThe photic blink reflex can be quantified with video recording of the palpebral fissure. The photic blink reflex has potential utility as an alternative to the pupil light reflex in assessing asymmetric pathologies of the afferent visual pathway, especially in eyes with pharmacologically dilated or unreactive pupils.
Details
- Title: Subtitle
- Ophthalmology in the Blink of an Eye: The Light-Induced Eyelid Reflex
- Creators
- Cyrus X Colah - University of IowaNitsan Duvedan-Strier - Rambam Health Care CampusEmma M HartnessRandy H Kardon
- Resource Type
- Journal article
- Publication Details
- Journal of neuro-ophthalmology, Vol.45(2), pp.243-248
- DOI
- 10.1097/WNO.0000000000002358
- PMID
- 40275454
- NLM abbreviation
- J Neuroophthalmol
- ISSN
- 1536-5166
- eISSN
- 1536-5166
- Publisher
- Wolters Kluwer; PHILADELPHIA
- Grant note
- This material is based upon work supported (or supported in part) by the Department of Veterans Affairs, Veterans Health Administration, Iowa City VA Health Care System, Office of Research and Development, Rehabilitation Research and Development Service, cRambam Health Care Campus, in Haifa Israel
In the spirit of mentoring, as exemplified by Dr. W. Hoyt, this publication has a shared authorship. Cyrus Colah, MD was a medical student at the time we first started investigating the photic blink reflex, and the data he collected were part of the Research with Distinction medical degree he obtained at the University of Iowa. He is now a Neurology resident at Columbia University. Dr. Nitsan Duvedan-Strier was a neuro-ophthalmology fellow with us from Israel at the time we were testing subjects and she helped greatly with the recruiting and analysis of the video-based data that were collected. She is now Attending Physician on faculty in the Ophthalmology Department at the Rambam Health Care Campus, in Haifa Israel. Emma Hartness was a medical student at the time of data collection and helped tremendously in the organization and analysis of the data. She recently matched at the University of Iowa for her residency in Ophthalmology. I am also greatly indebted to my research Program Coordinator, Julie Nellis, BSN, and Pieter Poolman, PhD, Research Scientist and Engineer.
- Language
- English
- Electronic publication date
- 04/25/2025
- Date published
- 06/2025
- Academic Unit
- Iowa Neuroscience Institute; Ophthalmology and Visual Sciences
- Record Identifier
- 9984813295002771
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