The use of automated photo-analysis of pupil size in different levels of ambient illumination to aid diagnosis of Horner syndrome

Simon Barnard
Department of Optometry & Visual Science, Hadassah Academic College, Israel

A fully automated hand held photo-ophthalmic device was used to measure pupil size under binocular conditions in 143 consecutive patients presenting for a primary care eye examination. The technique used to gather data will be described. An independent study showing the accuracy of this method when measuring fixed anatomical features will be reviewed1. Data showing distribution of anisocoria will be presented2. A protocol will be described to show how this method may be used to detect changes in anisocoria size in two different levels of ambient illumination. One case of previously undiagnosed acquired Horner syndrome in an adult and four cases of Horner in babies and young children will be presented.


  1. Rosen C et al (2015) Visible Iris Diameter with the Volk Eye Check Device, British Contact Lens Association conference, 29th-31st May, Liverpool, UK
  2. Barnard S et al (2015)The distribution of anisocoria in a group of unelected patients attending a primary care optometry practice, 31st Annual Pupil Colloquium, Oxford University, UK , September 2015