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Introduction: The pupillary light reflex (PLR) is the constriction of the pupil in response to light. The PLR in response to a pulse of light follows a complex waveform that can be characterized by several parameters. It is a sensitive marker of acute neurological deterioration, but is also sensitive to the background illumination in the environment in which it is measured. To detect a pathological change in the PLR, it is therefore necessary to separate the contributions of neuro-ophthalmic factors from ambient illumination. Illumination varies over several orders of magnitude and is difficult to control due to diurnal, seasonal, and location variations. Methods and results: We assessed the sensitivity of seven PLR parameters to differences in ambient light, using a smartphone-based pupillometer (Al Pupillometer, Solvemed Inc.). Nine subjects underwent 345 measurements in ambient conditions ranging from complete darkness (<5 Ix) to bright lighting (<10,000 Ix). Lighting most strongly affected the initial pupil size, constriction amplitude, and velocity. Nonlinear models were fitted to find the correction function that maximally stabilized PLR parameters across different ambient light levels. Next, we demonstrated that the lighting-corrected parameters still discriminated reactive from unreactive pupils. Ten patients underwent PLR testing in an ophthalmology outpatient clinic setting following the administration of tropicamide eye drops, which rendered the pupils unreactive. The parameters corrected for lighting were combined as predictors in a machine learning model to produce a scalar value, the Pupil Reactivity (PuRe) score, which quantifies Pupil Reactivity on a scale 0-5 (0, non-reactive pupil; 0-3, abnormal/'sluggish" response; 3-5, normal/brisk response). The score discriminated unreactive pupils with 100% accuracy and was stable under changes in ambient illumination across four orders of magnitude. Discussion: This is the first time that a correction method has been proposed to effectively mitigate the confounding influence of ambient light on PLR measurements, which could improve the reliability of pupillometric parameters both in pre-hospital and inpatient care settings. In particular, the PuRe score offers a robust measure of Pupil Reactivity directly applicable to clinical practice. Importantly, the formulae behind the score are openly available for the benefit of the clinical research community. [ABSTRACT FROM AUTHOR]

Prototype optical microscopes, built to pursue developments in advanced imaging techniques, need specific opto-mechanical constructions: preferably with high flexibility in the elements' arrangement, easy access to the optical paths, straightforward integration with external optical subsystems-light sources and detectors-as well as good mechanical stability. Typically they are either built around an adapted commercial microscope body or as a home-brewed setups, based on standard opto-mechanical elements, and neither solution delivers the desired characteristics. We developed a series of versatile microscope design for prototype optical microscopes in various configurations that use folding mirror(s) to maintain the optical paths horizontal throughout most of the setup. All prototypes use many standard opto-mechanics in the excitation and detection paths, which simplifies the construction and maintenance of the microscopes. The proposed opto-mechanical arrangement proved to be useful in building an upright as well as inverted microscopes, in particular Raman microscopes in various configurations. Horizontal arrangement simplified greatly the optical alignment and enabled for fast modifications in the setup-both key advantages at the prototyping stage. Last but not least, the laser safety of the optical system increased. The versatile microscope platform, based around the idea of the horizontal beam arrangement, can easily be adopted to many microscope configurations and to a variety of components that potential users might want to incorporate into them. RESEARCH HIGHLIGHTS: We design, fabricate, and test a compact, versatile opto-mechanics for prototyping optical microscopes in various configurations. Horizontal layout along most of the optical paths provides excellent access to the light beams, allows for using standard components and increases the laser safety., (© 2024 Wiley Periodicals LLC.)