Abstract: The most common pupillary manifestations of autonomic neuropathy in diabetic patients include decreased pupillary diameter, reduction of pupillary constriction and dilation, and decreased sensitivity to anticholinergic drugs. Diabetic autonomic neuropathy is associated with pupillary diameter, and the change of pupillary diameter is of diagnostic value for early diabetic autonomic neuropathy. As a simple, inexpensive, accurate and sensitive method for the detection of early diabetic autonomic neuropathy, pupil diameter measurement has the potential to improve the prognosis of patients with diabetic neuropathy. (Int Rev Ophthalmol, 2021, 45: 495-498)

Key words: pupil diameter, diabetes mellitus, diabetic autonomic neuropathy