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Purpose: The pupillary light reflex is a useful diagnostic tool used to assess the function of the eye and the visual system. The increased interest in testing the pupillary light reflex is the discovery that the intrinsically photosensitive retinal ganglion cells are involved in the reflex physiology. The aim of this study was to evaluate the usefulness of POLWROCHROM pupillometer, developed at the Wroclaw University of Technology, to study the pupillary light reflex to chromatic stimuli taking into account the photosensitive retinal ganglion cells activity., Material and Methods: The pupillary light reflex to 10 sec. light pulse were recorded. In the experiment, a long wavelength (640 nm bandwidth) red light and a short wavelength (470 nm bandwidth) blue light were used at 2 different light luminance levels (10 cd/m2 and 100 cd/m2)., Results: The greatest pupil response is obtained for short wavelength (blue) light at a high luminance level, whereas the markedly lower pupil response was obtained for long (red) wavelength light at a low luminance level., Conclusions: The observed sensitivity of the pupillary light reflex response to color and intensity of the light stimulus was similar to known from literature the results of in vitro photosensitive retinal ganglion cells electrophysiological activity study. The described system and measurement technique can provide a new tool in testing the pupillary light reflex to chromatic stimuli enabling the assessment of photosensitive retinal ganglion cells activity and identification of pupillary light reflex components derived from photoreceptors and ganglion cells, and therefore may become a clinical pupil test which allows differentiation between disorders affecting photoreceptors and those affecting retinal ganglion cells.

Examination of the pupils' light reaction and estimation of the pupils' diameter are the components of the routine physical examination of a patient. Disturbances in pupils' light reaction, unequal size of the pupils indicate damage of the nervous system and require careful diagnosis, both neurological and ophthalmological. Different aspects of anatomy, physiology and the most common pathological syndromes associated with disturbed pupils' light reaction and unequal diameters of the pupils were presented in the article. Early diagnosis and proper treatment can allow to improve prognosis in the analyzed patient group.

On the basis of current literature, clinical and neuropathologic features of idiopathic autonomic neuropathy is presented. Idiopathic autonomic neuropathy is a disease characterized by acute or subacute onset, monophasic course over a period of several years, it is often preceded by an infection. The spectrum of autonomic changes ranges from cholinergic or adrenergic dysfunction to pandysautonomia, leading to heterogeneity of its clinical features. Possible sympathetic system abnormalities found in autonomic neuropathy are: poor pupillary response to light in darkness, orthostatic hypotension leading to syncope, hypotension without compensatory tachycardia, ejaculation disturbances and vasomotor instability. Possible parasympathetic dysfunctions are: salivation and lacrimation disturbances, absent pupillary constriction to light and near gaze, gastrointestinal tract immobility and impairment of gastrointestinal function, atonic bladder with large residual volume, erectile impotence. Pandysautonomia is thought to result from an immune mediated mechanism and responds well to plasmaferesis and intravenous immunoglobin therapy leading to gradual, sometimes not full, recovery. Moreover in this article we pay attention to the clinical value of many tests like cardiovascular or pharmacological studies in the diagnosis of pandysautonomia and in differentiation of pre- and postganglionic changes. In order to diagnose idiopathic autonomic neuropathy one has to rule out a large number of diseases with autonomic dysfunction e.g.: diabetes, malignant neoplasms, acute intermittent porphyria, Shy-Drager syndrome, Riley-Day's dysautonomia, Parkinson's disease, amyloidosis and others.

The reaction of the pupil for light was checked in 25 patients with an unilateral retinal detachment. The sore eye and the fellow-eye were examined separately. The deterioration of the reaction was dependent on the area of detachment and on the condition of the macula.