Bridging the 23-hour examination gap
In most ICUs, neurological pupil examinations happen once per nursing shift. Between those checks, changes in intracranial pressure go undetected. PupiLUX gives every nurse the ability to perform quantitative pupillometry in 7 seconds.
The monitoring gap in neurocritical care
Neurological pupil assessment is a cornerstone of neurocritical care monitoring. Changes in pupillary reactivity can signal rising intracranial pressure, herniation, or neurological deterioration — often before other vital signs change.
Yet in practice, pupil checks happen only every 8-12 hours during nursing assessments. The IMPETUS 2025 study across 23 Indian medical colleges (n=2,018) documented this gap: in the hours between examinations, clinicians make neurological decisions with no neurological data.
Traditional penlight examination is subjective, with inter-observer agreement as low as 50% for sluggish reactions. Two nurses examining the same patient may record different findings.
Quantitative data, every hour, by any nurse
PupiLUX turns any iPhone into a quantitative pupillometer. A nurse positions the phone, the app voice-guides the 7-second bilateral test, and on-device AI produces a 2-page PDF with 6 parameters per eye — all without specialized training.
- 7-second bilateral PLR measurement — both eyes in a single recording
- 6 quantitative parameters per eye: BPD, CP, LAT, MCV, ADV, T75
- RAPD (relative afferent pupillary defect) scoring for asymmetry detection
- Voice-guided workflow — no pupillometry training required
- PDF report is the documentation — no charting overhead
- Works in dark rooms and dim ICU lighting
Key Evidence
Inter-observer agreement for penlight pupil assessment is as low as 50% for sluggish reactions, demonstrating the need for quantitative measurement.
Couret D, Boer W, Chabrier S, et al.. “Reliability of standard pupillometry practice in neurocritical care” Crit Care, 2016.
Automated pupillometry shows significantly higher inter-rater reliability than manual assessment (ICC 0.95 vs 0.52).
Olson DM, Stutzman SE, Saju C, et al.. “Interrater reliability of pupillary assessments” Neurocrit Care, 2016.
NPi < 3 predicted intracranial hypertension episodes with 80% sensitivity. Quantitative changes preceded ICP spikes by up to 15.9 hours.
Jahns FP, Miroz JP, Messerer M, et al.. “Quantitative pupillometry for the monitoring of intracranial hypertension in patients with severe traumatic brain injury” Crit Care, 2019.
NPi integrates multiple pupillary parameters into a single 0-5 score, enabling standardized trending across nursing shifts.
Shoyombo I, Aiyagari V, Saddawi-Konefka D, et al.. “Understanding the relationship between the Neurologic Pupil Index and constriction velocity values” JCM, 2018.
Ready to try PupiLUX?
100 free tests included on install. No credit card required.
Frequently Asked Questions
Can a nurse perform the test without pupillometry training?
Yes. PupiLUX is voice-guided from start to finish. The app tells the operator exactly how to position the phone, when to hold still, and when the test is complete. No prior experience with pupillometry is needed.
How does PupiLUX compare to NeurOptics NPi-300?
PupiLUX measures the same underlying pupillary light reflex using your iPhone's camera and torch. It produces 6 quantitative parameters per eye and a RAPD score. PupiLUX is a measurement and screening tool — it provides quantitative data for clinical interpretation by the treating physician.
What parameters does PupiLUX measure?
Six parameters per eye: Baseline Pupil Diameter (BPD), Constriction Percentage (CP), Latency (LAT), Maximum Constriction Velocity (MCV), Average Dilation Velocity (ADV), and 75% Recovery Time (T75). Plus a bilateral RAPD score.
PupiLUX is not a diagnostic device. For informational and screening purposes only. All clinical decisions must be made by qualified healthcare professionals.