Attenuation of the pupillary light reflex in anxious patients.

1. The miotic responses evoked by brief light stimuli were compared between a group of 10 patients suffering from generalized anxiety disorder and 10 age- and sex-matched healthy control subjects. 2. Resting pupil diameter in the dark did not differ significantly between the two groups. 3. In both groups, the amplitude of the light reflex was linearly related to the logarithm of the intensity of the light stimulus; responses in the anxious patient group had consistently lower amplitudes than those in the control group. 4. In both groups, the time taken for 75% recovery of the baseline pupil diameter following a light stimulus was linearly related to the logarithm of the light intensity; the 75% recovery times did not differ significantly between the two groups. 5. It is suggested that these results are consistent with a greater supranuclear inhibition of the parasympathetic oculomotor reflex arc in the anxious patients.