The Importance of Quantitative Pupillometry Today and What it Will Bring in the Future
Pupillometry has been around for centuries — dating back to Robert Whytt, an 18th century Scottish professor in theoretical medicine, who first coined the reflexive action of "sympathy" as it relates to the pupils and neurology. He even determined it was a cyst inhibiting the reflexive action in a hydrocephalic child, giving us one of the first documented diagnoses of a neurological challenge using pupillometry. But where is pupillometric medical technology today, and how has modern medicine expanded on Dr. Whytt's knowledge?
Many Haven't Evolved Best Practices Since the 18th Century
It's not surprising that many adopt the philosophy of "if it's not broken then don't fix it." Pupillometry is a powerful tool outright that never needed much expansion after inception. Most innovation has come from new protocols to conduct the test rather than improving upon the technology itself — which is why the penlight remains popular today. It's good enough to do very good medical work. But there is indeed a better way to implement pupillary testing, and that's where Quantitative Pupillary Light Reflex (qPLR) enters the picture.
qPLR Is a Non-Invasive Tool to Help You See the Detail
It wasn't until the late 20th century that pupillary testing technology started to be improved upon. Major advances in cameras and computers allowed new inventions to expand upon the status quo. The advent of qPLR via hardware apparatus, rather than a penlight, offered a new route to understanding the dynamic motion of the pupil. Research quickly expanded the neurological territory in which qPLR could be useful — and it's a big territory, given how integrated a role the PLR pathway plays within the brain itself.
Pixel-level accuracy allows clinicians to capture all the important details like latencies and hippus that would otherwise be challenging to accurately observe with the naked eye.
The Pupil Tells the Story the Brain Needs to Say
Quantitative Pupillometry is particularly important today as it provides an objective, repeatable method for evaluating and monitoring many neurological conditions. A common example is concussions, which is a growing concern in sports, military, and healthcare. Many research articles have indicated the utility of qPLR on this front, but the most prominent — and certainly the largest study — encompassed over twenty thousand patients. Two orders of magnitude more than any other qPLR study to date. What it outlines is that qPLR detects changes in the pupils indicative of a concussion, helping medical professionals make timely diagnoses and monitor recovery over time for safe return to learning and activities.
But why stop at concussion? qPLR is being actively used for addiction recovery and drug assessments, and is going further into modern neurological challenges including neurodegenerative diseases such as Alzheimer's and Parkinson's disease, early diagnosis of autism spectrum disorder, and multiple sclerosis.
The Future of qPLR Is in the Hands of the Patients
Now that clinicians and modern medicine have caught on, it's time to ask: what if we got qPLR vitals data whenever we needed it, not just at the clinic? Advances in telemedicine and telehealth have provided an easy access route for smartphone tests to be conducted at home — enabling patients to provide data more consistently to their caretakers outside of the office at all times of day.
That's the future of qPLR. Patients and medical professionals working more closely together to help deliver the care the patient needs and outcomes the clinician desires.