Pupillary Dilation in Research: More than Meets the Eye

Abstract

Purpose: Pupil dilation is a commonly used procedure in vision research. While often considered a minimal risk procedure, there is the potential for significant adverse effects.

Methods: Currently, there is variance in practices and protocols among researchers and institutions, perhaps due to a lack of guidelines for safe pupil dilation practices in research settings. In this perspective, we explore variables that can increase the potential for adverse effects and provide suggestions to limit their impact. Prior to dilation, an investigator can assess an individual's medical status and drug regimen when deciding upon a mydriatic agent to be used.

Results: Assessing the angle through a variety of methods (i.e. penlight test, van Herick slit lamp, optical coherence tomography, gonioscopy) can also prevent inappropriate dilation of pupils with concerning anatomical features. During dilation, an investigator should look to limit the potential of infection and use caution in repeat dosing of dilation-resistant pupils.

Conclusions: Post-dilation, an investigator should closely monitor eyes with elevated risk factors and improve an individual's health literacy on angle closure complications. When combined with proper informed consent processes regarding adverse effects, the aforementioned can allow for risk mitigation in studies using pupil dilation.

Keywords:

• Dilation
• human subjects
• safety
• anterior segment

Acknowledgements

The authors thank Amber Irons and Hannah Sheppard their contributions to this work. We thank Teresa Patitucci, PhD for drawing Figure 3.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author (JC) upon reasonable request.

Additional information

Funding

Research reported in this publication was supported in part by the National Center for Advancing Translational Sciences, National Institutes of Health, Award Number UL1T R001436. This investigation was conducted in a facility constructed with support from the Research Facilities Improvement Program, Grant Number C06RR016511, from the National Center for Research Resources, NIH. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.