Pupillary Changes Research Articles

Clinical and Outcome Analysis in Head Injury Patients with Fahr's Disease.

Context:Fahr's disease (FD) is a rare neurodegenerative disorder. Head injury in patients with FD is an uncommon occurrence.Aim:The aim is to evaluate clinical and outcome characteristics in traumatic head injury patients with FD.Settings and Design:Retrospective cohort study.Materials and Methods:This retrospective cohort study includes 13 patients of FD presenting as head injury in neurosurgical emergency between September 2018 and February 2021. Each patient was evaluated in terms of demographic profile, Glasgow coma scale (GCS) at admission, severity of head injury, type of head injury, preexisting clinical features of FD, radiological findings, Glasgow outcome score (GOS), family history of FD, and biochemical abnormalities. Patients were also evaluated for dichotomized outcome (Good recovery: GOS 5–4 versus Poor recovery: GOS 1–3) and gender differences in FD presentation.Statistical Analysis Used:Fisher's exact test and unpaired t-test were used. P < 0.05 was considered statistically significant.Results:Neurological symptoms (69.2%), neuropsychiatric manifestations (46.1%) and extrapyramidal features (38.5%) were preexisting in these patients. Seizure (61.5%) was the most common neurological manifestation. Depression (23.1%) and anxiety disorder (15.4%) were common psychiatric disorders seen. Akathisia (23.1%) followed by tremor (15.4%) were predominant extrapyramidal presentations. On dichotomized outcome analysis, preexisting neurological, neuropsychiatric, and extrapyramidal manifestations due to FD were not associated significantly with outcome following head injury. GCS at admission, severity of head injury and pupillary changes were significantly associated with outcome (P < 0.05). Neuropsychiatric features (P = 0.0210) were significantly more in females suffering from FD.Conclusions:Neurological features in FD predominate over neuropsychiatric and extrapyramidal symptoms. FD does not affect outcome following head injury.

Promotion of school engagement through dialogic teaching practices in the context of a teacher professional development programme

This study was conducted in the context of a teacher professional development programme that aimed to improve dialogic teaching in the classroom, and it describes the programme and examines the change in teachers' dialogic teaching practices and pupils' classroom engagement during the programme. Data on pupils' school engagement were collected using classroom video recordings and students' self-ratings at the end of the lesson including dialogic teaching practices. The participants comprised seven in-service teachers and their 140 pupils (10- to 15-year-olds) from two comprehensive schools. The findings indicated positive change in the use of dialogic teaching practices and in observed pupils' school engagement during the programme. Moreover, pupils' help-seeking during lessons increased over the course of the programme. The study suggests that a structured professional development programme utilising video recordings with teacher reflections provides beneficial tools for promoting teachers' employment of dialogic interaction and pupils' school engagement.

Increasing workers comfort: experiment of the effect of color and lighting in assembly manufacture

Color and light are the main factors in the car manufacturing industry, with not much research, conducted on this topic, related to employee physical comfort. The factor affecting employee work comfort is the color factor and lighting time in their workplace environment. Color is the light, reflected by an object, then interpreted by the eye based on the light that hits the object. The value of the color wavelength in the spectrum of 380 nm to780 nm impacts worker performance. Good lighting will affect whether or not the room’s light conditions affect the illumination’s value. A good working room condition will affect the physical comfort of employees. Employee physical comfort has developed in many previous studies. However, research on the configuration of colors and lighting in the manufacturing industry’s work environment is still underdeveloped. This research aims to measure and determine the impact of color and lighting at specific color wavelengths on the illumination value and the employee’s physical comfort. It starts with studying the color, light, human comfort, then examines the effect on the manufacturing industry employees’ performance in the wiring installation assembly industry. Color and light settings are proven essential to get better human comfort. Green color with a wavelength of 490 nm to 570 can increase the highest illuminate average lux value of 12.43 %. Yellow can increase the heart rate by 4.85 %, while green can reduce Diastole by 2.95 % and Systole by 1.29 %. Pupillary size changes L by 23.17 % and R by 21.43 %. The effect of green color and lighting time can increase the value of illumination and decrease heart rate, blood pressure, and pupil size so that it impacts the physical comfort of employees.

Supporting psychosocial development of a pupil – a proposal of a new model of a psychological and pedagogical counselling centre

Psychological and pedagogical counselling is a multidimensional activity that is permanently inscribed in the school environment. The main goal of counselling in schools is to recognise educational, emotional and social needs of adolescents as well as to offer them support in solving problems and contribute to a perfect realisation of harmony in their development. Changes in pupils’ characteristics, emerging technologies, and paradigm shifts in the disciplines themselves predict unique opportunities and challenges for the future. In this paper I aim to present the activity of the psycho-pedagogical centres in a new perspective which is much more efficient and explicitly includes counselling actions and psychological support for pupils, their parents and teachers. The model under discussion brings many benefits in the field of counselling activity within the school at different levels. Therefore, it contributes to a higher level of effectiveness of psycho-pedagogical activities. The relations with the families and teachers are an important element of the presented counselling activity. The family’s involvement in school life is achieved through participation in parents’ meetings, lectures, main teaching classes or in any other activity from or outside the curriculum. In intervention situations a specialist’s role is to guide the parents with the aim of modelling their children’s behaviour. The groups of specialists are not only permanently attentive to pupils’ needs but their emotional, social and behavioural problems as well. The specialist has a double role in the school environment: a preventive and an intervention role in order to deal with the above mentioned situations and difficulties. The presented article also includes an example of such a model in one of the schools.

Unified analytical method for Zernike coefficient transformation of scaled, rotated, and translated pupils based on Shack's vector multiplication.

Zernike polynomials play an essential role in characterizing and analyzing wavefront aberrations. Transformation of weighted coefficients for Zernike modes is required when pupil scaling, rotation, and/or translation exist. Here, a novel method based on Shack's vector multiplication is first proposed to derive the transformation relation. The derived modes resulting from pupil scaling, rotation, and/or translation for each individual mode are easily indicated via this method; thus, the effect of each kind of pupil change could be studied qualitatively and quantitatively. Its remarkable computational efficiency against the direct integral is demonstrated by simulation. The method introduced here provides a generalized methodology to analyze the relationship between weighted coefficients for different description basis sets.

A curious case of unilateral buphthalmos

Unilateral secondary angle-closure glaucoma due to uveitis is a rare presentation in a neonate. While the congenital pupillary membranes present predominantly with iris and pupillary changes, glaucoma being a late presentation in a milder form. We report an unusual presentation of a few weeks old baby, having unilateral buphthalmos, normal iris, flat anterior chamber, and elevated intraocular pressure with a pupillary membrane, causing secondary angle-closure glaucoma. There was indirect evidence of maternal infection during the antenatal period with raised IgG titers. The case was managed with anterior chamber reformation, iridectomy along with membranectomy, and did not require trabeculectomy.

Optimizing the usage of pupillary based indicators for cognitive workload.

The Index of Cognitive Activity (ICA) and its open-source alternative, the Index of Pupillary Activity (IPA), are pupillary-based indicators for cognitive workload and are independent of light changes. Both indicators were investigated regarding influences of cognitive demand, fatigue and inter-individual differences. In addition, the variability of pupil changes between both eyes (difference values) were compared with the usually calculated pupillary changes averaged over both eyes (mean values). Fifty-five participants performed a spatial thinking test, the R-Cube-Vis Test, with six distinct difficulty levels and a simple fixation task before and after the R-Cube-Vis Test. The distributions of the ICA and IPA were comparable. The ICA/IPA values were lower during the simple fixation tasks than during the cognitively demanding R-Cube-Vis Test. A fatigue effect was found only for the mean ICA values. The effects of both indicators were larger between difficulty levels of the test when inter-individual differences were controlled using z-standardization. The difference values seemed to control for fatigue and appeared to differentiate better between more demanding cognitive tasks than the mean values. The derived recommendations for the ICA/IPA values are beneficial to gain more insights in individual performance and behavior during, e.g., training and testing scenarios.

An analysis of school absences in England during the COVID-19 pandemic

BackgroundThe introduction of SARS-CoV-2, the virus that causes COVID-19 infection, in the UK in early 2020, resulted in the introduction of several control policies to reduce disease spread. As part of these restrictions, schools were closed to all pupils in March (except for vulnerable and key worker children), before re-opening to certain year groups in June. Finally, all school children returned to the classroom in September.MethodsHere, we analyse data on school absences in late 2020 as a result of COVID-19 infection and how that varied through time as other measures in the community were introduced. We utilise data from the Department for Education Educational Settings database and examine how pupil and teacher absences change in both primary and secondary schools.ResultsOur results show that absences as a result of COVID-19 infection rose steadily following the re-opening of schools in September. Cases in teachers declined during the November lockdown, particularly in regions previously in tier 3, the highest level of control at the time. Cases in secondary school pupils increased for the first 2 weeks of the November lockdown, before decreasing. Since the introduction of the tier system, the number of absences with confirmed infection in primary schools was observed to be (markedly) lower than that in secondary schools. In December, we observed a large rise in the number of absences per school in secondary school settings in the South East and London, but such rises were not observed in other regions or in primary school settings. We conjecture that the increased transmissibility of the new variant in these regions may have contributed to this rise in secondary school cases. Finally, we observe a positive correlation between cases in the community and cases in schools in most regions, with weak evidence suggesting that cases in schools lag behind cases in the surrounding community.ConclusionsWe conclude that there is no significant evidence to suggest that schools are playing a substantial role in driving spread in the community and that careful monitoring may be required as schools re-open to determine the effect associated with open schools upon community incidence.

PHYSICAL EDUCATION BY DISTANCE LEARNING TECHNOLOGIES AS A FACTOR OF STUDENTS' HEALTHY LIFESTYLE

The article consider the issue of a healthy lifestyle of students in the process of their physical education while studying in higher education institutions. The urgency of the study due to significant problems in maintaining the health of young people on a national scale, due to the introduction of quarantine restrictions in educational institutions. The purposeof the study is to identify the possibilities of the discipline "Physical Education" by means of remote technologies in free economic education in the formation of skills of a healthy lifestyle of students. Based on the study, the use of a set of general scientific theoretical methods: analysis, synthesis, systematization, generalization. It is established that the implementation of the current educational process provides a priority before physical education – the preservation and change of pupils and students in the formation of their healthy lifestyle skills. The practice of using distance learning technologies in physical education of students is studied, the possibilities of such educational process in formation of motivations and needs of students in observance of the basic healthy ways of life in the conditions of quarantine are analyzed. It is determined that the latter should be reviewed: classes based on a personality-oriented approach, the availability of these recommendations for the formation of motivations for physical activity; providing opportunities for students to monitor indicators of individual development; acquisition of skills to increase valeological culture of nutrition; increase of motor activity in the modes of the school day and maintenance of the sanitary and hygienic mode. According to the results of the study, information on potential innovative distance technologies has been expanded to optimize the impact of physical education on the student's personality in order to educate users of a healthy lifestyle during student years, which will ensure their future health.

Clinical, Surgical and Outcome Predictive Factor Analysis of Operated Acute Subdural Hematoma Cases: A Retrospective Study of 114 Operated Cases at Tertiary Centre

Abstract Objective To analyze clinical, surgical and outcome predictive factors of operated acute subdural hematoma (SDH) cases for prognostication and surgical outcome prediction. Material and Methods This retrospective study includes 114 patients operated for acute SDH in the Department of Neurosurgery of IMS BHU, Varanasi, India, a tertiary care center, between 1 August 2018 and 1 November 2019. Each patient was evaluated for age, sex, mode of injury, localization of hematoma, clinical presentation, comorbidity, severity of injury, best motor response, CT findings, and Glasgow outcome scale (GOS) at discharge. The outcome was also evaluated by further making a dichotomized group using GOS in death/dependent (1–3) versus independent (4–5). Statistical tests were done using the GraphPad Prism version 8.3.0. Results The most common age group operated upon in this study was the 40 to 60 years age group (n = 45, 39.48%). Males were 78% with male to female ratio of 3.56:1. The most common clinical presentation was altered sensorium (98.25%). The most common comorbidity was hypertension (n = 32, 28.07%). GCS at admission, severity of injury, pupillary changes, and best motor response (p &lt; 0.0001) were significantly associated with surgical outcome. Conclusion GCS at admission, severity of injury, pupillary changes, and best motor response were significantly (p &lt; 0.05) associated with surgical outcome. Age and gender of patients were not found to be significantly associated.

Variable abnormality of the melanopsin-derived portion of the pupillary light reflex (PLR) in patients with Parkinson's disease (PD) and parkinsonism features.

Ascertain and quantify abnormality of the melanopsin-derived portion of the pupillary light reflex (PLR) in patients with Parkinson's disease (PD) and parkinsonism features based on a statistical predictive modeling strategy for PLR classification. Exploratory cohort analysis of pupillary kinetics in non-disease controls, PD subjects, and subjects with parkinsonism features using chromatic pupillometry. Receiver operating characteristic (ROC) curve interpretation of pupillary changes consistent with abnormality of intrinsically photosensitive retinal ganglion cells (ipRGCs) was employed using a thresholding algorithm to discriminate pupillary abnormality between study groups. Twenty-eight subjects were enrolled, including 17 PD subjects (age range 64-85, mean 70.65) and nine controls (age range 48-95, mean 63.89). Two subjects were described as demonstrating parkinsonism symptoms due to presumed Lewy body dementia and motor system atrophy (MSA) respectively. On aggregate analysis, PD subjects demonstrated abnormal but variable pupillary dynamics suggestive of ipRGC abnormality. Subjects with parkinsonism features did not demonstrate pupillary changes consistent with ipRGC abnormality. There was no relationship between levodopa equivalent dosage or PD severity and ipRGC abnormality. The pupillary test sensitivity in predicting PD was 0.75 and likelihood ratio was 1.2. ipRGC deficit is demonstrated in PD subjects; however, the degree and constancy of abnormality appear variable.

A Harsh Test of Far-field Scrambling with the Habitable-zone Planet Finder and the Hobby–Eberly Telescope

Abstract The Habitable-zone Planet Finder (HPF) is a fiber-fed precise radial velocity (RV) spectrograph at the 10 m Hobby–Eberly Telescope (HET). Due to its fixed-altitude design, the HET pupil changes appreciably across a track, leading to significant changes of the fiber far-field illumination. HPF’s fiber scrambler is designed to suppress the impact of these illumination changes on the RVs—but the residual impact on the RV measurements has yet to be probed on-sky. We use GJ 411, a bright early type (M2) M dwarf to probe the effects of far-field input trends due to these pupil variations on HPF RVs. These large changes (∼2x) in the pupil area and centroid present a harsh test of HPF’s far-field scrambling. Our results show that the RVs are effectively decoupled from these extreme far-field input changes due to pupil centroid offsets, attesting to the effectiveness of the scrambler design. This experiment allows us to test the impact of these changes with large pupil variation on-sky, something we would not easily be able to do at a conventional optical telescope. While the pupil and illumination changes expected at these other telescopes are small, scaling from our results enables us to estimate and bound these effects, and show that they are controllable even for the new and next generation of RV instruments in their quest to beat down instrumental noise sources toward the goal of a few cm s − 1 .

Higher choroidal thickness and lower choriocapillaris blood flow signal density based on optical coherence tomography angiography in diabetics

Diabetes mellitus (DM) is one of the fastest growing chronic diseases in the world and one of the main causes of vision loss. Whether or not diabetic choroidopathy (DC) is involved in the initiation and progression of diabetic ocular complications needs to be explored. We included 54 diabetic eyes from 36 diabetic patients, and 54 healthy eyes from 32 control subjects after propensity scores matching. All of the subjects were given pupil light and dark adaptation examination and optical coherence tomography angiography (OCTA). Scotopic pupil diameter (SPD), pupil contraction amplitude, and velocity of pupil contraction of the diabetic group were significantly lower than that of the healthy control group (P < 0.05).Choroidal thickness at temporal quadrant (at 750 μm) and superior quadrant (at 1500 μm and 2250 μm) increased in diabetic group compared to control group(P < 0.05).In the diabetic group, choriocapillaris blood flow signal density (CCBFSD) in the macular area (diameter = 2000 μm) were significantly decreased compared with the healthy control group (P < 0.05). Apparent changes in pupil and choroidal blood flow were observed in the diabetic patients.

Pupil size differences between female and male patients after cataract surgery

PurposeTo evaluate the changes in pupil diameter in women and men after cataract surgery. The correlation of pupillary changes with the variables age and anterior chamber depth will be analyzed. MethodsThe values of 109 randomized eyes who underwent cataract surgery were obtained and divided into two groups, 71 women and 38 men. Pupil diameter was measured preoperatively and 3-months postoperatively using the pupillometer software of the Topolyzer Vario (Wavelight Laser Technologie AG). Anterior chamber depth was obtained with Pentacam® (Oculus). Differences in pupillary diameters were investigated and correlations with age and anterior chamber depth were analyzed. ResultsFor mesopic pupils, the male group had greater reduction in their postoperative pupillary diameter, −0.56 mm (−12.4%), than the female group, −0.38 mm (−8.2%), P = 0.025. Photopic postoperative pupils reduced to a lesser extent, yet more in men than in women (−0.11mm [−4.5%] vs. −0.04 [−1.6%], P = 0.048). Weak significant negative correlation was found between photopic pupillary changes in women with age (r = −0.24, P = 0.041), and positive correlation for mesopic pupillary changes in men with age (r = +0.34, P = 0.039). ConclusionsPatients experience pupil reduction after cataract surgery in general, but more in men than in women and for both photopic and mesopic lighting conditions. The differences are statistically significant and have moderate clinical relevance. Concerning pupillary changes, weak but opposite sign correlations were found between male/female gender and age.Trial registration number at ClinicalTrials.gov Identifier: NCT04286646.

Human and Human-Interfaced AI Interactions: Modulation of Human Male Autonomic Nervous System via Pupil Mimicry.

Pupillary alterations in virtual humans induce neurophysiological responses within an observer. Technological advances have enabled rapid developments in artificial intelligence (AI), from verbal systems, to visual AI interfaces with the ability to express, and respond to emotional states of a user. Visual AI interfaces are able to change their physical parameters, such as pupil diameter. Pupillary changes can alter heart rate, however, effects on heart rate variability (HRV) are unknown. HRV, is an autonomic, non-conscious parameter which monitors sympathetic and parasympathetic nervous system (PNS) activity. N = 34 male participants aged between 19–33 were subjected to a number of conditions such as pupil dilation, constriction and blushing. The present research is the first to investigate the effects of virtual human interactions on human HRV. Outcomes of this study were obtained using eye tracking and HRV measurements. Pupil dilation relative to constriction presented in the female virtual partner induced a significant right pupillary diameter increase (p = 0.041) in human observers. Additionally, female virtual partner pupil constriction relative to dilation induced a significant increase in participants’ PNS HRV response (p = 0.036). These findings indicate the ability of a female virtual interaction partner to modulate parasympathetic autonomic functioning in young healthy male humans. This allows first insights into the effects of interacting with virtual AI interaction partners, on human autonomic functioning, and may aid development of future virtual humans, and their implementation into relevant clinical settings.

Probing infants' sensitivity to pupil size when viewing eyes.

Sensitive responding to eye cues plays a key role in human social interactions. Pupil size provides subtle cues regarding a social interaction partner's arousal states. The current study assessed infants' sensitivity to and preference for differences in pupil size. Specifically, we examined White 14-month-old infants' pupillary responses when viewing own-race and other-race (Asian) eyes with dilating, constricting, and static medium-sized pupils. Our results show that, independent of race, infants' pupils dilated more when viewing eyes with dynamically changing (dilating and constricting) pupils than when viewing eyes with non-changing, static, and medium-sized pupils. We also measured infants' looking preferences, showing that, independent of race, infants preferentially attended to eyes with dilated pupils. Moreover, our results show that infants orient more quickly to pupillary changes in own-race eyes than in other-race eyes. These findings demonstrate that infants detect, but do not mimic, changes in pupil size in others and show a preference for eyes with dilated pupils.

Application of simple head cooling combined with gangliosides in neonatal hypoxic-ischemic encephalopathy

Objective To investigate the effect of simple head cooling combined with ganglioside therapy on neonatal hypoxic-ischemic encephalopathy (HIE) and its clinical efficacy. Methods A total of 100 children with HIE admitted in the neonatal ward of our hospital from August 2018 to October 2020 were selected as the research objects, and were divided into control group and observation group according to the random number table method, with 50 cases in each group. The control group was treated with gangliosides, and the observation group was treated with simple head cooling combined with gangliosides. Observe and compare the clinical performance improvement time, the level of relevant hematological examination indexes before and after treatment, and the neonatal behavioral neurological assessment (NBNA), clinical efficacy, and adverse reactions. Results The improvement time of convulsions, disturbance of consciousness, pupil changes, hypotonia, and gastrointestinal dysfunction in the observation group was significantly lower than that in the control group (all P＜0.001). After treatment, the NSE, IL-6, CK, CK-MB of the two groups of children were significantly lower than before treatment, and the serum calcium and NBNA scores were significantly higher than before treatment, and the decrease or increase in the observation group was significantly higher than that of the control Group (all P＜0.001). The total effective rate of treatment of children in the observation group (82.00%) was higher than that of the control group (62.00%) (P&lt;0.05). There were no obvious adverse reactions in both groups. Conclusion The simple head cooling combined with gangliosides in the treatment of HIE can improve the clinical symptoms, blood test index levels, and NBNA scores. The clinical effect is clear and superior to the single use of gangliosides.

A Recurrent Neural Network for Attenuating Non-cognitive Components of Pupil Dynamics.

There is increasing interest in how the pupil dynamics of the eye reflect underlying cognitive processes and brain states. Problematic, however, is that pupil changes can be due to non-cognitive factors, for example luminance changes in the environment, accommodation and movement. In this paper we consider how by modeling the response of the pupil in real-world environments we can capture the non-cognitive related changes and remove these to extract a residual signal which is a better index of cognition and performance. Specifically, we utilize sequence measures such as fixation position, duration, saccades, and blink-related information as inputs to a deep recurrent neural network (RNN) model for predicting subsequent pupil diameter. We build and evaluate the model for a task where subjects are watching educational videos and subsequently asked questions based on the content. Compared to commonly-used models for this task, the RNN had the lowest errors rates in predicting subsequent pupil dilation given sequence data. Most importantly was how the model output related to subjects' cognitive performance as assessed by a post-viewing test. Consistent with our hypothesis that the model captures non-cognitive pupil dynamics, we found (1) the model's root-mean square error was less for lower performing subjects than for those having better performance on the post-viewing test, (2) the residuals of the RNN (LSTM) model had the highest correlation with subject post-viewing test scores and (3) the residuals had the highest discriminability (assessed via area under the ROC curve, AUC) for classifying high and low test performers, compared to the true pupil size or the RNN model predictions. This suggests that deep learning sequence models may be good for separating components of pupil responses that are linked to luminance and accommodation from those that are linked to cognition and arousal.

Pupil response is modulated with optokinetic nystagmus in transparent motion.

When two visual patterns moving in opposite directions are superimposed on the same depth plane, they appear to have two transparent surfaces moving independently (transparent motion). Additionally, the direction of the slow phase of optokinetic nystagmus (OKN) corresponds to the direction of motion that dominates the perceptual appearance. This study examines whether pupil changes correspond to the luminance of the dominated objects related to the transition of the slow-phase direction in OKN following objects. Stimuli consisted of two random dot patterns of different luminance that moved in opposite directions. The results showed that pupil size changed in accordance with the luminance of the pattern in the slow phase of OKN immediately after OKN transition. This suggests that pupil size is modulated with OKN in transparent motion.

Comparison of effects of mydriatic drops (1% cyclopentolate and 0.5% tropicamide) on anterior segment parameters.

Purpose:The purpose of this study is to investigate and compare the effects of cyclopentolate and tropicamide drops on anterior segment parameters in healthy individuals.Methods:Two hundred and fifty-eight eyes of 129 healthy volunteers were included in this randomized clinical study. Cyclopentolate 1% drop was applied to 75 (58%) participants (group 1) and tropicamide 0.5% drop was applied to 54 (42%) participants (group 2). Flat keratometry (K1), steep keratometry (K2), axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), white-to-white (WTW) distance, pupil diameter, total pupil offset and intraocular lens (IOL) power were measured before and after drops, using Lenstar 900 optical biometry.Results:The increase in CCT, ACD, pupil diameter, and pupil offset was significant in group 1 after the drop (P < 0.05), while the increase in ACD, pupil diameter, and pupil offset was significant in group 2 (P < 0.05). When the two groups were compared, there was no significant difference in K1, K2, CCT, ACD, WTW, pupil diameter, pupil offset, and IOL power (using Sanders–Retzlaff–Kraff T formula) changes after drops (P > 0.05), whereas the change in AL was significant (P = 0.01).Conclusion:The effects of cyclopentolate and tropicamide drops on anterior segment parameters were similar; they did not make significant changes in K1, K2, AL, WTW, and third-generation IOL power calculation. However, ACD values significantly changed after these drops; thus, measuring anterior segment parameters before mydriatic agents should be taken into account particularly for fourth-generation IOL formulas and phakic IOL implantation. The change in pupil offset, which can be important in excimer laser and multifocal IOL applications, was not clinically significant.