Pupilla eye exam simulator: frequently asked questions
Short, direct answers about what Pupilla is, what you can practice on it and how students and educators use it.
About Pupilla
What is Pupilla?
Pupilla (Pupilla Eye Exam Lab) is a free, browser-based eye exam simulator for optometry and ophthalmology education. It gives you a virtual patient with 43 simulated conditions and real clinical tools — penlight, occluder, prisms, retinoscope and trial lenses — so you can perform the exam and watch the eyes respond. It also includes a streak retinoscopy simulator, a refraction simulator, a visual pathway lesion simulator, 3D extraocular muscle anatomy, a case quiz and learning guides in English and Arabic.
Is Pupilla free? Do I need an account?
Yes, Pupilla is completely free and needs no account, sign-up or installation. Open pupillalab.com in a modern browser and start examining.
Who is Pupilla for?
Pupilla is built for optometry students, medical students, ophthalmology residents, orthoptists, optometrists and ophthalmologists who want to practice or revise the eye exam, and for educators who teach it. It is useful for self-study, lectures, small-group teaching and practical (OSCE-style) exam preparation.
What is a good free eye exam simulator for optometry and ophthalmology students?
Pupilla is a free eye exam simulator that covers the core bedside eye exam in one place: pupils and RAPD, anisocoria, cover and alternate cover tests, Hirschberg and Krimsky, ocular motility and cranial nerve palsies, streak retinoscopy, refraction and visual field defects from visual pathway lesions. The eyes respond to the tools you use — a swinging penlight, an occluder or a prism — instead of showing a static picture, and the interface is available in English and Arabic.
What can I practice on Pupilla?
You can practice: the swinging flashlight test and RAPD grading; anisocoria (Horner syndrome, Adie tonic pupil, Argyll Robertson pupil); the cover–uncover and alternate cover tests; Hirschberg and Krimsky; ductions, versions and the H-test; third, fourth and sixth nerve palsies; INO, one-and-a-half syndrome and gaze palsies; nystagmus; streak retinoscopy; refractive errors and astigmatism; visual field defects; and extraocular muscle anatomy.
How realistic is the simulation?
Pupilla models the physiology behind each sign rather than playing fixed animations. Pupils constrict and redilate with light and near effort, a relative afferent pupillary defect is graded on a continuous scale, covered eyes drift and refixate with saccades, prisms shift the corneal light reflex by the amount you place, and the retinoscopic reflex changes speed, brightness and direction with the refractive error. It is still a teaching model: real patients vary, and supervised clinical practice remains essential.
Is Pupilla available in Arabic?
Yes. The whole simulator interface can be switched between English and Arabic from the language button, and the learning guides and this FAQ are published in both languages. Arabic pages start at pupillalab.com/ar/.
Does Pupilla work on phones and tablets?
Yes, Pupilla runs in current versions of Chrome, Safari, Edge and Firefox on computers, tablets and phones. A larger screen is more comfortable for the full exam simulator and the visual pathway simulator.
What is hand tracking and is my camera video uploaded?
Hand tracking is an optional mode that lets you hold the penlight or occluder with your real hand in front of your webcam. The hand-tracking model runs inside your browser, so the camera video is processed on your device and is not uploaded. The camera turns on only when you enable hand tracking.
Can Pupilla be used to diagnose patients?
No. Pupilla is an educational simulator, not a medical device. It is meant for learning and revision and does not replace clinical examination, supervised training or professional judgement.
Learning with Pupilla
How can I practice the swinging flashlight test for RAPD online?
Open the exam simulator with an RAPD in the right eye, pick up the penlight and swing it between the eyes, spending two to three seconds on each. Both pupils dilate when the light reaches the affected eye. The RAPD guide explains the technique, grading and causes.
Is there a free online streak retinoscopy simulator?
Yes. Pupilla's streak retinoscopy simulator lets you sweep the streak, read with and against motion, and neutralize the reflex with lenses for myopia, hyperopia and astigmatism. The retinoscopy guide covers working distance and the principal meridians.
How do I learn to tell a tropia from a phoria with the cover test?
Use the cover–uncover test first: if the uncovered eye moves to take up fixation when you cover the other eye, there is a tropia; if the covered eye moves back when it is uncovered and no tropia was seen, there is a phoria. In Pupilla you can compare esotropia with esophoria side by side, and the cover test guide walks through each step.
Can Pupilla help me prepare for an OSCE or practical eye exam?
Yes. You can rehearse the sequence of a pupil, motility and cover test station on a patient whose signs match a real condition, check your interpretation in the clinical explanation under the eyes, and test yourself with the visual pathway case quiz. Practicing the words you would say to an examiner alongside the simulator works well.
Can educators use Pupilla in lectures and teaching?
Yes. Pupilla is free to use in lectures, tutorials and skills labs, and it works well on a projector. Links can open a specific condition directly, for example pupillalab.com/#exam?condition=cn3-od for a right third nerve palsy, and adding ?lang=ar opens the simulator in Arabic.
How can I learn visual field defects from visual pathway lesions?
Open the visual pathway simulator, place a lesion on the optic nerve, chiasm, optic tract, optic radiations or occipital cortex, and watch the matching field defect appear on both eyes' charts. The visual field defects guide lists each lesion site and its classic pattern.
How do I cite Pupilla?
Cite Pupilla as a website: Pupilla — Eye Exam Lab. Interactive eye exam simulator. https://pupillalab.com (accessed day month year). To cite a specific guide, use its title and URL; every guide shows a ready-made citation at the end.
Learning guides
- RAPD and the swinging flashlight test Perform the swinging flashlight test, grade a Marcus Gunn pupil and know what causes it.
- Anisocoria: Horner syndrome, Adie tonic pupil and third nerve palsy Decide which pupil is abnormal and tell Horner, Adie, Argyll Robertson and third nerve palsy apart.
- The cover test: cover–uncover, alternate cover and prism cover test Tell a tropia from a phoria and measure the angle with prisms, step by step.
- Hirschberg and Krimsky tests: measuring strabismus with the corneal light reflex Read the corneal light reflex, convert millimeters to prism dioptres and neutralize with prisms.
- Ocular motility and the H-test: ductions, versions and the nine positions of gaze Trace the H, know which muscle each gaze position tests and interpret limited movements.
- Third, fourth and sixth cranial nerve palsies and the three-step test Recognize each ocular motor palsy, run the three-step test and spot the red flags.
- Internuclear ophthalmoplegia (INO), one-and-a-half syndrome and gaze palsies Localize INO, one-and-a-half syndrome, gaze palsies and Parinaud syndrome from eye movements.
- Types of nystagmus: gaze-evoked, downbeat, upbeat, see-saw and pendular Describe nystagmus properly and know what downbeat, upbeat, see-saw and pendular patterns suggest.
- Extraocular muscles: anatomy, actions and nerve supply Origins, insertions, actions and nerve supply of the six eye muscles — and why actions change with gaze.
- Streak retinoscopy: with motion, against motion and neutralization Read with and against motion, neutralize both meridians and correct for working distance.
- Refractive errors and astigmatism: myopia, hyperopia and Sturm's conoid Understand myopia, hyperopia and astigmatism, read a prescription and correct for vertex distance.
- Visual pathway lesions and the visual field defects they cause Localize a lesion from its field defect, from the optic nerve to the occipital cortex.