Assessing Pupil Light Reflex Metrics in Glaucoma: Insights from a Systematic Review and Meta-Analysis

May 1, 2026Ophthalmology ScienceOpen Access

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Key Points

This review aims to identify the affected pupil light reflex metrics and optimal stimulus conditions for detecting glaucoma.
Comprehensive literature search across PubMed, Embase, and Google Scholar from June 2023 to March 2024.
Inclusion of studies comparing PLR metrics in glaucoma and healthy controls.
Meta-analysis using Hedges' g to assess the impact of glaucoma on specified PLR metrics.
Meta-analysis revealed significant effects on amplitude of constriction, latency, velocity, and postillumination pupil response in mild glaucoma.
Sensitivity for detecting PLR deficits was highest with stimuli lasting longer than one second after less than five minutes of dark adaptation.
In severe glaucoma, significant changes were noted in amplitude of constriction, duration of dilation, velocity, and PIPR, with larger effect sizes.

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Systematic review evaluates pupil light reflex changes in glaucoma, suggesting improved disease detection methods.

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Moniritilaki et al. (2026) studied this question.

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