There Is Significant Within-Subject Variation in the Time from Light Stimulus to Maximum Pupil Constriction Among Healthy Controls

Background: Handheld quantitative pupilometers (QPs) measure each phase of the pupillary light reflex (PLR) and provide a summary score based on these values. One phase of the PLR is the period of time from the onset of light exposure to the maximum constriction of the pupil, also known as time to maximum constriction (tMC). Although tMC has been found to vary significantly among patients with neurological injury, there are no studies reporting tMC in healthy controls. This study addresses this gap. Methods: Subjects in this prospective observational study were healthy controls who provided paired (left and right eye) QP readings during four separate observations over the course of 2 days. The tMC was derived by determining the smallest observed pupil size during videos filmed at 30 frames per second, and we assessed within-subject variability using the coefficient of variance and intraclass correlation coefficient (ICC). Results: Fifty subjects provided 380 QP readings (190 left eye and 190 right eye). Subjects primarily identified as female (80%), non-Hispanic (86%), white (62%), and