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Anatomy of the pupillary reflexes

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The size of the pupils depends on the balance of sympathetic and parasympathetic activity supplying the iris:

  • sympathetic activity tends to dilate the pupil
  • parasympathetic activity tends to constrict the pupil

The pathway of the pupillary light reflex consists of:

  • retinal receptor cells
  • bipolar cells
  • ganglion cells
  • optic nerve and tract
  • pretectal nucleus of the high midbrain
  • Edinger-Westphal nucleus
  • efferent two neurone pathway via the oculomotor nerve
  • constrictor muscle of the iris

It should be noted that the lateral geniculate nucleus of the thalamus and the cerebral cortex are not involved in the pupillary reflexes. Hence a patient who is cortically blind will have intact light reflexes.


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