All the intervals were 2 s, and the dynamics of pupil diameters on both sides were continuously recorded. The protocol was as follows: infrared light was applied to both pupils, followed by visible light to the right pupil, infrared light to both pupils, visible light to the left pupil, and then infrared light to both pupils. Methods: Twenty-five healthy volunteers and five ICU patients with intracranial lesions on only the left side were assessed using the Hitomiru ® pupilometer. Purpose: To evaluate the clinical ability of the Hitomiru ® pupilometer to assess the pupil diameter and the pupillary light reflex of healthy volunteers and patients with intracranial lesions in an intensive care unit (ICU).

The pupil diameter and light reflex of both pupils can be measured simultaneously therefore, both indirect and direct light reflexes can be assessed. This device is a two-glass type pupilometer with a video recording system. Consequently, we have developed a new automatic mobile pupilometer, the Hitomiru ®, with Hitomiru Co., Ltd. Hence, an indirect pupillary light reflex, including those under irradiation to the opposite side of pupil, cannot be evaluated. Although a mobile pupillometer has been developed and is available in clinical settings, this device can only assess one pupil at a time.

2Division of Disaster and Emergency Medicine, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japanīackground: Physicians currently measure the pupil diameter and the pupillary light reflex with visual observations using a ruler and a traditional penlight, leading to possibly inaccurate and subjective assessments.

1Department of Emergency, Disaster and Critical Care Medicine, Hyogo College of Medicine, Nishinomiya, Japan.Joji Kotani 1,2 *, Hiroyuki Nakao 1, Isamu Yamada 1,2, Atsushi Miyawaki 1, Naomi Mambo 1 and Yuko Ono 2

Miotic pupil