Pupillary light reflex

Also called: Photopupillary reflex · Pupil reflex

Shine a light into one eye and both pupils shrink, even the eye in the dark. The wiring crosses in the midbrain so that the two pupils react together. You can watch it in a mirror.

How common

Everyone

Does this happen to you?

How it works

The pupil is a hole. Its size is set by two muscles in the iris. One is a ring that squeezes the hole smaller. The other is a set of spokes that pull it wider4. In bright light the pupil is about 1.5 to 4 mm across4. In the dark it opens to about 3 to 8 mm4.

The reflex starts in the retina. Light-sensing cells send a signal up the optic nerve. Some fibres peel off before the visual cortex and go to a small cluster of cells in the midbrain called the pretectal area3. From there the signal goes to both sides of the midbrain, not just one. Each side then sends an order down the oculomotor nerve to its own iris. Both pupils shrink1.

That crossing is the key. Light in the left eye alone shrinks the right pupil too. This is called the consensual response1. It means that both pupils react together, whichever eye the light falls on1.

Doctors use the reflex constantly. A torch swung from one eye to the other should keep both pupils small. If the pupils get bigger when the light moves to a certain eye, that eye is sending a weak signal. This is a Marcus Gunn pupil. It usually points to damage in that eye’s optic nerve or retina2. Emergency doctors check the reflex to test the brain stem, because brain stem damage can make it abnormal1.

Try it

  1. Stand at a mirror in a dim room. Wait a minute for your pupils to open up.
  2. Cover your left eye with your hand and keep it there for 20 seconds.
  3. Watch the pupil of your right eye in the mirror.
  4. Take your hand away quickly. Both pupils shrink together, even though only the left eye saw a change.
  5. Now hold a phone torch beside your right eye, pointing at it from the side, while you watch your left eye in the mirror. The left pupil shrinks too.

Use a normal torch, not a laser and not anything painfully bright.

Is it a problem?

No. The reflex itself is not a problem. It runs automatically in every sighted person and needs no attention1. Doctors rely on it precisely because it is so reliable, using it to check brain function in people who cannot respond in other ways1.

What is worth mentioning to a doctor is a change in the reflex itself:

  • one pupil that stops reacting,
  • two pupils of clearly different sizes,
  • a pupil that reacts to near objects but not to light5.

Sources and further material

  1. Wikipedia Relative afferent pupillary defect (Marcus Gunn pupil) The sign doctors look for when one optic nerve is damaged.
  2. Wikipedia Pretectal area Where the signal crosses to the other side.
  3. Wikipedia Pupil
  4. Wikipedia Argyll Robertson pupil Pupils that react to near objects but not to light, called light-near dissociation.

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