Dr. Tatham of the Hamilton Glaucoma Center and Ophthalmology at the University of California, San Diego, recently conducted a study to evaluate the ability of bimanual automated pupillography to discriminate between healthy subjects and patients with glaucoma. The cross-sectional observational study included 116 subjects with bilateral eyes, including 66 patients with glaucoma in at least one eye and 50 healthy controls, all from the DiagnosticInnovations in Glaucoma Study. Glaucoma was categorized by changes in progressive glaucoma under repeated abnormal standard automated visual field testing (SAP) or stereoscopic imaging. All subjects underwent automated pupillometric testing using the RAPDx pupil tracer (Konan Medical USA, Inc., Irvine, CA). The primary outcome measures included the creation of curves to assess the diagnostic ability of pupillary response parameters to white, red, green, yellow and blue full-field and focal stimuli.ROC regression models were used to investigate the effect of disease severity and asymmetry on diagnostic ability. The results of the study showed that the maximum area under the curve (AUC) for any single parameter ROC was 0.75. disease asymmetry (p < 0.001), but not disease severity (p = 0.058), had a significant effect on diagnostic ability. The mean age of the sample (60.9 years) at SAP interocular difference arbitrary mean deviation (MD) of 0, 5, 10, and 15 dB corresponded to AUCs of 0.58, 0.71, 0.82, and 0.90, respectively. the mean interocular difference MD was 2.2 ± 3.1 dB. the AUC for the best combination of parameters was 0.85; however, the bias-corrected cross-validation of these parameters The AUC for cross-validation of these parameters was only 0.74. The study confirmed that although the pupil marker tracing method has good ability to detect asymmetric glaucoma, it has poor diagnostic ability for symmetric glaucoma.