Figure 3. Pupillometry data from two patients without command following.

This figure depicts results from a healthy volunteer with unsuccessful command following (A, B) and a 62-year old male in the ICU with subarachnoid hemorrhage and deep sedation (Richmond Agitation-Sedation Scale score of −4) who served as a negative control (C, D). Data from each subject are presented twice and in 2 different formats (raw measurements A and C; annotated data B and D). Minor artifacts due to blinking or eye movements are seen in A, but not B (because of sedation-induced impairment of the blink reflex). In the healthy volunteer, pupillary dilation was noted in only three out of five mental arithmetic tasks, which did not meet our prespecified criteria for successful command following (≥4 pupillary dilations, 80%). Minor random fluctuations in the pupillary diameter are seen in the unconscious sedated ICU patient. #, p-value <0.0001; ✓, pupillary dilation; ÷, absence of pupillary dilation; n, number of measurements; m, median pupillary size; mm, millimeter.