Quantitative assessments of pupillary light reflexes in neurocritically ill patients

The pupillary light reflex is a component of bedside neurological examinations in neurological intensive care units (neuroICUs). A quantitative pupillometer provides a non-invasive and objective pupil reactivity parameter clinically significant for changes in the pupillary light reflex in neuroICUs. This article reviews the physiology and importance of the pupillary light reflex and the parameters of quantitative pupillometers. Moreover, this review discusses the clinical applications of quantitative pupillometers for post-cardiac arrest prognostication and monitoring of elevated intracranial pressure and neurological worsening in stroke, seizures, and other neurological diseases in the neuroICU. Quantitative pupillometry is a routine part of neurological examinations and an important monitoring tool for neurological diseases in neuroICUs.