Analysis of Various Factors Affecting Pupil Size in Patients with Glaucoma

Background: Pupil size is an important factor in predicting post-operative satisfaction. We assessed the correlation between pupil size, measured by Humphrey static perimetry, and various affecting factors in patients with glaucoma.

Methods: In total, 825 eyes of 415 patients were evaluated retrospectively. Pupil size was measured with Humphrey static perimetry. Comparisons of pupil size according to the presence of glaucoma were evaluated, as were correlations between pupil size and various factors, including age, logMAR best corrected visual acuity (BCVA), retinal nerve fiber layer (RNFL) thickness, spherical equivalent, intraocular pressure, axial length, central corneal thickness, white-to-white, and the kappa angle.

Results: Pupil size was significantly smaller in glaucoma patients than in glaucoma suspects (p < 0.001) or the normal group (p < 0.001). Pupil size decreased significantly as age (p < 0.001) and central cornea thickness (p = 0.007) increased, and increased significantly as logMAR BCVA (p = 0.02) became worse and spherical equivalent (p = 0.007) and RNFL thickness (p = 0.042) increased. In patients older than 50 years, pupil size was significantly larger in eyes with a history of cataract surgery.

Conclusions: Humphrey static perimetry can be useful in measuring pupil size. Pupil size was significantly smaller in eyes with glaucoma. Other factors affecting pupil size can be used in a preoperative evaluation when considering cataract surgery or laser refractive surgery.