11/24/2023 0 Comments Left pupil size chartHow to cite this article: George AS, Abraham AP, Nair S, Joseph M. The sensitivity of clinical examination in detecting early anisocoria is poor. Key Message: The nearly 14% incidence of physiological anisocoria must be kept in mind while assessing the pupils of neurosurgical patients. Keywords: Anisocoria, neurosurgery, physiological, simple Patients at risk of developing uncal herniation may, therefore, benefit from routine bedside pupillary assessment with a portable device such as a pupillometer. With a prevalence of anisocoria of 13.7%, the positive predictive value was 0.46, and the negative predictive value was 0.91.Ĭonclusions: The prevalence of physiological anisocoria was 13.7%, which is less than what has previously been reported. The clinical measurement of anisocoria, therefore, showed a specificity of 0.91 and a sensitivity of 0.46. Ninety-seven subjects (13.7%) also had anisocoria on clinical examination, however, only 45 of them had measured anisocoria. Ninety-seven (13.7%) had measured anisocoria on photography. The average pupillary diameter of the subjects was 4.99 mm. Results: Of the 708 subjects, 361 (51%) were males. ![]() A difference in pupillary size of 0.4 mm or more was considered anisocoria. ![]() This was followed by photography of the subjects' pupils using a digital camera secured on a tripod at a fixed distance from the subject's face. In a closed room with uniform ambient lighting, the subjects' pupils were examined clinically and the presence or absence of anisocoria was recorded. Materials and Methods: A total of 708 voluntary subjects between the ages of 20–69 years who had no history of ophthalmologic or neurological disease other than refractive error were included in the study. Aim: We aimed to estimate the prevalence of physiological anisocoria and also evaluate the accuracy of clinical assessment of anisocoria employed in routine bedside examination.
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