Pupil Evaluation at Rest
- * The pupils should be equal in size, round, and react symmetrically to light and accommodation. At rest, the pupils may exhibit small fluctuations in size, commonly called hippus.
- Each pupil should be round with a smooth contour and should be situated in the center of the iris. Ocular, rather than neurologic, diseases often cause abnormalities in pupillary shape and position.
- Pupil size is widely variable and decreases with age: a rough estimate for normal pupil size in ambient light is from 2 to 6 mm. The level of illumination and the distance of the object being viewed will affect pupillary size; therefore, resting pupil size should be assessed in ambient and dim light, viewing both near and far objects.