To compare the pupil sizes measured using the automatic pupillometer and pupil card.

We measured pupil sizes using a pupil card (Rosenbaum Card, J.G. Rosenbaum, Cleveland, OH, USA) and automated pupillometer (VIP™-200, Neuroptics Inc., San Clemente, CA, USA) under different luminous intensities in 60 eyes of 60 patients who visited the ophthalmology clinic during August 2013.

Under the photopic condition, pupil sizes measured using automated pupillometer were larger than those measured using the pupil card with statistical significance. The 2 techniques were not different under mesopic and scotopic conditions. Under all light conditions, automated pupillometer showed higher inter-rater reliability. Under the scotopic condition, pupil sizes measured using the pupil card were smaller than pupil sizes measured using the pupillometer according to increased pupil size.

When compared with pupil card, automated pupillometer provided accurate and reliable measurement with small inter-rater variation and was easy and simple to use. However, based on comparable measurements of both techniques under mesopic and scotopic conditions, the pupil card can be used as preoperative evaluation when considering the cost of purchase and maintenance.