pupillary physiology stuart r. steinhauer, ph.d. biometrics research program university of...
TRANSCRIPT
![Page 1: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/1.jpg)
Pupillary PhysiologyStuart R. Steinhauer, Ph.D.Biometrics Research Program
University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System
(http://www.wpic.pitt.edu/research/biometrics)
Society for Psychophysiological Research Workshop, Boston, September 14, 2011
![Page 2: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/2.jpg)
little is achieved by one alone,
Thanks to all of the following:
Greg J. Siegle, Ph.D.Ruth Condray, Ph.D.
Samay Jain, M.D.Beatrice Chakraborty, Psy.D.
Adam L. Clarke, B.S.Erin E. Kelly, B.S.
J. Richard Jennings, Shirley Y. Hill, Lisa A. Morrow
Gad Hakerem, Joseph Zubin, Samuel Sutton
Work has been supported by the Department of Veterans Affairs and National Institute of Mental Health
![Page 3: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/3.jpg)
![Page 4: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/4.jpg)
![Page 5: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/5.jpg)
Pupil of the Eye.net
• Pupil of the Eye ... United in Spirit ... In Service to All
• • “Bahá'u'lláh once compared the coloured people
to the black pupil of the eye surrounded by the white. In this black pupil you see the reflection of that which is before it, and through it the light of the Spirit shines forth. In the sight of God colour makes no difference at all, He looks at the hearts of men. That which God desires from men is the heart...”
![Page 7: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/7.jpg)
http://www.ndrs.scot.nhs.uk/Train/Handbook/drh-21.htm
![Page 8: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/8.jpg)
http://www.army-technology.com/features/feature1644/feature1644-4.html
![Page 9: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/9.jpg)
![Page 10: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/10.jpg)
![Page 11: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/11.jpg)
www.center4sight.com/anisocoria
![Page 12: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/12.jpg)
![Page 13: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/13.jpg)
![Page 14: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/14.jpg)
Measuring sustained cognitive load via pupil dilation
![Page 15: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/15.jpg)
Horizontal Diameter Measured to .025 mm, 60/sec
![Page 16: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/16.jpg)
Average Pupillary Light Reaction
5.5
6
6.5
7-2
00
20
0
60
0
10
00
14
00
18
00
22
00
26
00
30
00
34
00
Time (ms)
Pu
pil
Dia
mte
r (m
m)
Start
End
Light
Amplitude of Light Reaction
![Page 17: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/17.jpg)
![Page 18: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/18.jpg)
Alexandritis, 1985
![Page 19: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/19.jpg)
n.III Oculomotor Nucleus
![Page 20: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/20.jpg)
Edinger Westphal Nucleus (4 on right figure)
![Page 21: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/21.jpg)
![Page 22: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/22.jpg)
![Page 23: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/23.jpg)
Alexandritis, 1985
![Page 24: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/24.jpg)
![Page 25: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/25.jpg)
Hypothalamic Nuclei
![Page 26: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/26.jpg)
![Page 27: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/27.jpg)
Posterior Hypothalamic
Nuclei(sympathetic)
![Page 28: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/28.jpg)
Lowenstein, 1955
Dilation
Constriction
12 Oculomotor nucleus
7 Hypothalamus
Inhibition of
![Page 29: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/29.jpg)
White & Depue, J.Pers.Soc.Psychol., 1999, quoting Ranson & Clark, 1959
![Page 30: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/30.jpg)
White & Depue, J.Pers.Soc.Psychol., 1999, quoting Ranson & Clark, 1959
![Page 31: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/31.jpg)
Autonomic Contributions to Pupillary Dilation
Parasympathetic Sympathetic
Time Course of Immediate Processing:
Prestimulus; 300-500 msec (motor) 600-1000 msec
1100-1500 msec
Task sensitivity:
Increasing Ambient Light:
Sustained Processing (memory, effort) Motor Initiation Anticipatory Responses Increased response with smaller initial diameter
Immediate Processing of Stimulus Significance Orienting Responses No substantial differences (within limits)
![Page 32: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/32.jpg)
Experimental Dissociation of Sympathetic and Parasympathetic Components
Parasympathetic Sympathetic
Recording in Dark:
Recording in Light:
Minimize Dilation Increase Dilation
Normal Dilation Normal Dilation
Block sphincter:
Block dilator:
No Dilation Normal Dilation
Normal Dilation No Dilation
Tasks: Digit Span Serial Subtraction Motor Responses (Voluntary, Cued)
“Oddball” Counting & Choice Reaction Guessing Missing Stimulus Paradigm
![Page 33: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/33.jpg)
Begin Data Collection
Verbalize
End Data Collection
Instructions:
Subtract 7
or Add 1
Serial “Subtraction” Task
Reticular Activating System inhibits Edinger-Westphal center of Oculomotor Nucleus
Prefrontal Cortex (PFC) inhibits E-W &
Activates Posterior Hypothalamus
5 sec 60 sec
![Page 34: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/34.jpg)
Pupil Diameter Increases With Task Demand
Steinhauer et al., Int. J. Psychophysiology, 2004
![Page 35: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/35.jpg)
What can interfere with the light reflex? (other than brightness, visual field, hue)
• Fear (Szabadi, Bitsios, 1996)
• Apprehension (Loewenfeld, 1958; 1993)
• Motor response (Loewenfeld, 1993; Gavriysky, 1991)
• Cognition (Steinhauer, 2000)
![Page 36: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/36.jpg)
Light Reaction Amplitude by Cue Delay
1.1
1.2
1.3
1.4
1.5
1.6
1.7
1.8
No Cue -1000 -750 -500 -250 0 250 500
Cue to Light onset (msec)
Lig
ht
Rea
ctio
n (
mm
)
Control =8
Motor Response cued by tone inhibits Light Reaction even after onset of light stimulus
Light Duration = 1000 msec, Tone Duration = 40 msec
![Page 37: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/37.jpg)
Effect of Task Demand on Light Reaction
![Page 38: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/38.jpg)
Light Reaction, Superimposed at Baseline
Placebo
-1
-0.8
-0.6
-0.4
-0.2
0
0.2
-200 200 600 1000 1400 1800 2200 2600 3000 3400
Time (msec)
Ch
ang
e in
D
iam
eter
(m
m)
Placebo, Subtract 7
Placebo, Add 1
Placebo, No Task
Light Stimulus
(n = 29 healthy subjects)
![Page 39: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/39.jpg)
Prestimulus Pupil Diameter
Serial -7Serial +1Light Only
Pre
-stim
ulus
Dia
met
er (
mm
)7.0
6.5
6.0
5.5
5.0
4.5
GROUP
Control
Schizophrenic
Alcoholic
Group: F1,35 = 5.6, p=0.008
Condition: F 1.4,50.1 = 47.1 , p < 0.001
![Page 40: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/40.jpg)
Constriction: Group by Condition
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
Control = 12 Alcohol = 15 Schizophrenic = 11
Ch
ang
e in
Dia
met
er (
mm
)
Light Only
Add 1
Subtract 7
Condition: F 1.6,56.6 = 5.99, p = 0.007
![Page 41: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/41.jpg)
Loewenfeld, 1993
![Page 42: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/42.jpg)
Loewenfeld, 1993
Dapiprazole
![Page 43: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/43.jpg)
Blockade of Sphincter or Dilator on Diameter in relation to Task Demand
Steinhauer et al., Int. J. Psychophysiology, 2004
![Page 44: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/44.jpg)
Average Pupillary Light Reaction
5.5
6
6.5
7-2
00
20
0
60
0
10
00
14
00
18
00
22
00
26
00
30
00
34
00
Time (ms)
Pu
pil
Dia
mte
r (m
m)
Start
End
Light
Amplitude of Light Reaction
![Page 45: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/45.jpg)
Placebo Dapiprazole Tropicamide
4
4.5
5
5.5
6
6.5
7
7.5
8
-20020
060
010
0014
0018
0022
0026
0030
0034
00 -20020
060
010
0014
0018
0022
0026
0030
0034
00-2
00 20060
010
0014
0018
0022
0026
0030
0034
00
Time (msec)
Dia
met
er (
mm
) Subtract 7
Add 1
No Task
No Task and Add 1 superimposed
(Block Dilator) (Block Sphincter)
![Page 46: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/46.jpg)
![Page 47: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/47.jpg)
Steinhauer & Zubin, 1982
![Page 48: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/48.jpg)
![Page 49: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/49.jpg)
Steinhauer & Hakerem, 1992
![Page 50: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/50.jpg)
Cued Response: Placebo
-0.02
0
0.02
0.04
0.06
0.08
0.1
-992 -592 -192 208 608 100814081808 22082608
Time (msec)
Ch
an
ge
in P
up
il D
iam
ete
r (m
m)
Cued-Dark
Cued-Light
![Page 51: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/51.jpg)
Self Initiated Response: Placebo
-0.07
-0.05
-0.03
-0.01
0.01
0.03
0.05
-992 -592 -192 208 608 1008 1408 1808 2208 2608
Time (msec)
Ch
an
ge
in P
up
il D
iam
ete
r (m
m)
Placebo-Dark
Placebo-Light
![Page 52: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/52.jpg)
(n = 11 healthy subjects)
![Page 53: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/53.jpg)
(n = 11 healthy subjects)
![Page 54: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/54.jpg)
Harrison et al., SCAN, 2006
![Page 55: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/55.jpg)
![Page 56: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/56.jpg)
![Page 57: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/57.jpg)
![Page 58: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/58.jpg)
Irene E. Loewenfeld, Ph.D.
Dept. of Neurology, Columbia University
Kresge Eye Institute, Wayne State University
![Page 59: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/59.jpg)
Funded by the National Library of Medicine Grant #G08 LM07919-02 A collaboration of the Spencer S. Eccles Health Sciences Library, University of Utah, and the North American
Neuro-Ophthalmology Society (NANOS)
![Page 60: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/60.jpg)
H. Stanley Thompson, M.D. Randy Kardon, M.D.
Neuro-opthalmology Service, University of Iowa
![Page 61: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/61.jpg)
Gad Hakerem & Irene Loewenfeld, 2005 Pupil Colloquium, NY
![Page 62: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/62.jpg)
Eckhard Hess
![Page 63: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/63.jpg)
Daniel Kahneman, Ph.D. Jackson Beatty, Ph.D.
![Page 64: Pupillary Physiology Stuart R. Steinhauer, Ph.D. Biometrics Research Program University of Pittsburgh School of Medicine & VA Pittsburgh Healthcare System](https://reader031.vdocument.in/reader031/viewer/2022032203/56649ddc5503460f94ad3bc5/html5/thumbnails/64.jpg)
Iridology?