Mentoring Session & Hands-On Training with Dr. Stuart Stoll & YMDC

Defining a Small Pupil

Defining a small pupil may depend on…

• Surgeon skill & technique.

• Not all pupils of the same size are the same.

• Pupil size is only one factor.

• Iris Tissue Properties – dilates, bound down, atrophic, floppy, etc.

Causes of Small Pupil

• Age-Related – Iris Atrophy

• Medications – chronic pilocarpine

• IFIS – Intraoperative Floppy Iris Syndrome

• Posterior Synechiae – uveitis, trauma, prior surgery, angle closure

• PEX – atrophy of dilator and sphincter muscles

• Diabetes – autonomic neuropathy partially denervating the dilator and sphincter muscles; and rubeosis

Managing Small Pupil

• Intracameral Medication: Phenylephrine / Epinephrine

• Viscodilation – cohesive agents

• Posterior Synechiolysis – cyclodialysis spatula or viscoelastic cannula

• Pupil Stretching – Kuglen Hook for push-pull  or Beehler Pupil Dilator

• Iris Hooks

• Pupil Expanding Devices:  Malyugin Ring   I-Ring   Xpand

SimulEYE’s Small Pupil and Xpand models are the perfect practice models to prepare for treating and managing small pupils using Ophthalmic Devices.

SimulEYE Small Pupil & Xpand Model

Our practice models ensure that training is optimized with hands on practice PRIOR to practicing on patients.

See the impact of our SimulEYE models as practice tools in the full presentation on Small Pupil Management below…