Sep 15, 2026 · 56 min · 15 segments
We assess the pupils in almost every significantly unwell or injured patient - but how much are they really telling us? It is easy to document 'pupils equal and reactive' and move on, yet a changing…
Okay, so today we're talking about something that we assess on pretty much every significantly unwell or injured patient, pupils.
And it is, let's be honest, really easy to give a quick guess of the size, see if they move, constrict, dilate, when the light is shone in on them, and that might be the job done.
But really going deep into the understanding of what pupillary assessment can tell us about acute pathologies, prognostics, and indications for treatment can help refine practice to make it excellent.
So in this episode, we're going to work all the way through from anatomy, physiology, James Yates-
... through to three clinical situations to help pull it all into context for what we're looking for and why.
And do you know what? I know you're pointing the finger at me there, Simon, and saying physiology, but I have been happier than a pig in...
This is taking me right back there because honestly, I mean, eyes are utterly remarkable, aren't they? You know, they allow us to interpret and interact with the world around us.
And I guess even more amazingly, that they're constantly adjusting and changing in response to the environments that we're in.
And I guess it's exactly that automatic adjustment that we're going to be going on to consider here, because changes in how the eye behaves can give us some really important clues around pathological processes that might be going on.
Now, as you can imagine, the processes underpinning all of this are, you know, slightly complicated.
Okay, so today we're talking about something that we assess on pretty much every significantly unwell or injured patient, pupils.
And it is, let's be honest, really easy to give a quick guess of the size, see if they move, constrict, dilate, when the light is shone in on them, and that might be the job done.
But really going deep into the understanding of what pupillary assessment can tell us about acute pathologies, prognostics, and indications for treatment can help refine practice to make it excellent.
So in this episode, we're going to work all the way through from anatomy, physiology, James Yates-
... through to three clinical situations to help pull it all into context for what we're looking for and why.
And do you know what? I know you're pointing the finger at me there, Simon, and saying physiology, but I have been happier than a pig in...
This is taking me right back there because honestly, I mean, eyes are utterly remarkable, aren't they? You know, they allow us to interpret and interact with the world around us.
And I guess even more amazingly, that they're constantly adjusting and changing in response to the environments that we're in.
And I guess it's exactly that automatic adjustment that we're going to be going on to consider here, because changes in how the eye behaves can give us some really important clues around pathological processes that might be going on.
Now, as you can imagine, the processes underpinning all of this are, you know, slightly complicated.
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