BMJ · 1987 · 179 citations · 7 references
MedicineEndocrinologyOptometryNeuro-optometryNeuroendocrinologyReproductive EndocrinologyDiabetes MellitusDiabetic NeuropathyHormonal InfluencesMydriatic AgentsPupil AbnormalitiesPupillary AbnormalitiesAdrenergic MydriaticsCardiac Vagal ControlCardiac Vagal TonePupil Dilation DisordersPupil Dilation MechanismsPupillary Abnormalities In DiabetesPupillary Autonomic DysfunctionVagal Dysfunction
Infrared television pupillometry was performed on 34 insulin-treated diabetic patients and 55 healthy subjects. Sixteen of the diabetic patients had pupils that failed to dilate normally in darkness. The occurrence of a small pupil was associated with cardiac vagal dysfunction and somatic sensory loss. The small pupil was found to be supersensitive to the mydriatic effect of topical 2% phenylephrine but normally sensitive to 0.5% hydroxyamphetamine eyedrops. It is concluded that the failure of the pupil to dilate in darkness in some diabetic patients is due to neuropathy of the sympathetic innervation.
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