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March 1943


Author Affiliations

From the neurologic service of Dr. I. S. Wechsler and the laboratories of the Mount Sinai Hospital.

Arch Ophthalmol. 1943;29(3):435-440. doi:10.1001/archopht.1943.00880150109004

One of the normal reactions seldom tested is the eyelid closure reaction. This reaction, also known as the orbicularis reflex, is actually an associated movement. It consists of a constriction of the pupil in conjunction with active contraction of the orbicularis oculi muscle and upward rolling of the eyeball. It is elicited as follows : The patient is asked to shut his eyes tightly, and when the eyelids are forcibly held apart, the examiner notices a slight constriction of the pupil.1

Although the lid closure reaction can be elicited in the normal person, it cannot always be observed unless careful pupillographic studies are made.2 Piltz3 found the reaction in only 1 of 23 persons. Pupillary constriction in association with lid closure was first noted in a patient in whom the light reflex was absent. Von Graefe,4 Westphal5 and Piltz3 each described the phenomenon in great