# Pupilla — Eye Exam Lab

> Pupilla (https://pupillalab.com) is a free, browser-based eye exam simulator for optometry and ophthalmology education, in English and Arabic. Learners examine a virtual patient with real clinical tools — penlight, occluder, prisms, near target, retinoscope and trial lenses — and the eyes respond according to the underlying physiology. It is an educational simulator, not a medical device.

Key facts:

- Free, no account or installation; runs in any modern browser on computers, tablets and phones.
- 43 simulated conditions: pupils (RAPD, Horner syndrome, Adie tonic pupil, Argyll Robertson pupil), cranial nerve II, III, IV and VI palsies, cavernous sinus syndrome, INO, one-and-a-half syndrome, gaze palsies, Parinaud syndrome, five nystagmus types, esotropia, exotropia, hypertropia, phorias, Duane and Brown syndromes, Hirschberg grading and pseudo-strabismus from angle kappa.
- Tests practiced: swinging flashlight test, light and near reflexes, cover–uncover, alternate cover and prism cover tests, Hirschberg and Krimsky tests, H-test ductions and versions, Bielschowsky head tilt, streak retinoscopy, trial-lens refraction, and visual pathway lesion localization.
- Audience: optometry and medical students, ophthalmology residents, optometrists, orthoptists, ophthalmologists and educators.
- Interface and learning guides in English and Arabic (Arabic pages under https://pupillalab.com/ar/; the app opens in Arabic with ?lang=ar).
- Deep links open a condition directly, e.g. https://pupillalab.com/#exam?condition=rapd-od (RAPD, right eye).
- Optional webcam hand tracking runs in the browser; camera video is not uploaded.

## Simulators

- [Eye Exam Simulator](https://pupillalab.com/#exam): A virtual patient with 43 conditions: penlight pupil exam and RAPD, cover tests, Hirschberg and Krimsky, ductions and versions, cranial nerve palsies, INO, gaze palsies and nystagmus.
- [Streak Retinoscopy Simulator](https://pupillalab.com/retinoscopy): Read with and against motion, find the principal meridians and neutralize the reflex for myopia, hyperopia and astigmatism.
- [Refraction Simulator](https://pupillalab.com/refraction-simulator): Change axial length, corneal curvature and astigmatism, then correct them with sphere, cylinder and axis trial lenses and watch Sturm's conoid collapse onto the retina.
- [Visual Pathway Simulator](https://pupillalab.com/visual_pathway): Place a lesion anywhere from the optic nerve to the occipital cortex and see the visual field defect, with lessons and a case quiz.
- [3D Eye Muscle Anatomy](https://pupillalab.com/#anatomy): Contract each extraocular muscle, see its action in the nine gaze positions and follow Hering's and Sherrington's laws.
- [Clinical Repertoire](https://pupillalab.com/repertoire): Condition summaries with presentation, signature findings, red flags, workup, treatment and differentials (English).

## Learning guides (English)

- [RAPD and the swinging flashlight test](https://pupillalab.com/learn/rapd-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](https://pupillalab.com/learn/anisocoria-horner-adie-pupil): 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](https://pupillalab.com/learn/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](https://pupillalab.com/learn/hirschberg-krimsky-test): 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](https://pupillalab.com/learn/ocular-motility-h-test): 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](https://pupillalab.com/learn/cranial-nerve-palsies-3-4-6): 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](https://pupillalab.com/learn/ino-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](https://pupillalab.com/learn/nystagmus-types): Describe nystagmus properly and know what downbeat, upbeat, see-saw and pendular patterns suggest.
- [Extraocular muscles: anatomy, actions and nerve supply](https://pupillalab.com/learn/extraocular-muscles-anatomy): 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](https://pupillalab.com/learn/streak-retinoscopy): Read with and against motion, neutralize both meridians and correct for working distance.
- [Refractive errors and astigmatism: myopia, hyperopia and Sturm's conoid](https://pupillalab.com/learn/refractive-errors-astigmatism): Understand myopia, hyperopia and astigmatism, read a prescription and correct for vertex distance.
- [Visual pathway lesions and the visual field defects they cause](https://pupillalab.com/learn/visual-pathway-field-defects): Localize a lesion from its field defect, from the optic nerve to the occipital cortex.

## أدلة التعلّم (العربية)

- [عيب الحدقة الوارد النسبي (RAPD) واختبار المصباح المتأرجح](https://pupillalab.com/ar/learn/rapd-swinging-flashlight-test): أجرِ اختبار المصباح المتأرجح، ودرّج حدقة ماركوس غن، واعرف أسبابها.
- [تفاوت حجم الحدقتين: متلازمة هورنر وحدقة آدي وشلل العصب الثالث](https://pupillalab.com/ar/learn/anisocoria-horner-adie-pupil): حدّد أي الحدقتين غير طبيعية، وميّز هورنر وآدي وأرجيل روبرتسون وشلل العصب الثالث.
- [اختبار التغطية: التغطية وكشف الغطاء، التغطية المتناوبة، واختبار التغطية بالمنشور](https://pupillalab.com/ar/learn/cover-test): ميّز الحول الظاهر من الكامن وقِس الزاوية بالمناشير خطوة بخطوة.
- [اختبارا هيرشبرغ وكريمسكي: قياس الحول بانعكاس الضوء على القرنية](https://pupillalab.com/ar/learn/hirschberg-krimsky-test): اقرأ انعكاس الضوء على القرنية، حوّل المليمترات إلى ديوبترات منشورية، وعادِل بالمناشير.
- [فحص حركات العين واختبار H: الحركات الأحادية والمترافقة واتجاهات النظر التسعة](https://pupillalab.com/ar/learn/ocular-motility-h-test): ارسم حرف H، واعرف العضلة التي يختبرها كل اتجاه، وفسّر محدودية الحركة.
- [شلل الأعصاب القحفية الثالث والرابع والسادس واختبار الخطوات الثلاث](https://pupillalab.com/ar/learn/cranial-nerve-palsies-3-4-6): تعرّف على شلل كل عصب محرك للعين، وطبّق اختبار الخطوات الثلاث، والتقط علامات الخطر.
- [شلل العين بين النوى (INO) ومتلازمة الواحد والنصف وشلل النظر](https://pupillalab.com/ar/learn/ino-gaze-palsies): حدّد موضع INO ومتلازمة الواحد والنصف وشلل النظر وباريناود من حركات العين.
- [أنواع الرأرأة: المُحدَثة بالنظر، الهابطة، الصاعدة، الأرجوحية والنواسية](https://pupillalab.com/ar/learn/nystagmus-types): صِف الرأرأة بدقة واعرف دلالة الأنماط الهابطة والصاعدة والأرجوحية والنواسية.
- [عضلات العين الخارجية: التشريح والوظائف والتعصيب](https://pupillalab.com/ar/learn/extraocular-muscles-anatomy): منشأ ومرتكز ووظيفة وتعصيب عضلات العين الست — ولماذا تتغير الوظيفة مع اتجاه النظر.
- [تنظير الشبكية بالشريط الضوئي: الحركة المتوافقة والمعاكسة والمعادلة](https://pupillalab.com/ar/learn/streak-retinoscopy): اقرأ الحركة المتوافقة والمعاكسة، وعادِل المحورين، وصحّح مسافة العمل.
- [الأخطاء الانكسارية واللابؤرية: قصر النظر وطول النظر ومخروط ستورم](https://pupillalab.com/ar/learn/refractive-errors-astigmatism): افهم قصر النظر وطول النظر واللابؤرية، واقرأ الوصفة، وصحّح مسافة الرأس.
- [آفات المسار البصري وعيوب الساحة البصرية الناتجة عنها](https://pupillalab.com/ar/learn/visual-pathway-field-defects): حدّد موضع الآفة من عيب الساحة البصرية، من العصب البصري إلى القشرة القذالية.

## FAQ

- [Pupilla FAQ (English)](https://pupillalab.com/faq): Answers about Pupilla, the free online eye exam simulator: who it is for, what you can practice (RAPD, cover test, Krimsky, retinoscopy, refraction, visual fields), Arabic support, cost and how to cite it.
- [الأسئلة الشائعة (العربية)](https://pupillalab.com/ar/faq): إجابات عن Pupilla (بيوبيلا)، محاكي فحص العين المجاني على الإنترنت: لمن هو، وما الذي تتدرب عليه (RAPD، اختبار التغطية، كريمسكي، تنظير الشبكية، قياس النظر، الساحة البصرية)، ودعم العربية، وكيفية الاستشهاد به.

## Clinical repertoire (English)

- [Aberrant Regeneration of the Third Cranial Nerve](https://pupillalab.com/repertoire/aberrant-regeneration-cn3): Oculomotor Synkinesis
- [Acanthamoeba Keratitis](https://pupillalab.com/repertoire/acanthamoeba-keratitis): Protozoan Corneal Infection
- [Acquired Cataract](https://pupillalab.com/repertoire/acquired-cataract): Lens Opacity — Nuclear / Cortical / PSC
- [Acute Angle-Closure Glaucoma](https://pupillalab.com/repertoire/acute-angle-closure-glaucoma): Pupillary Block — Ocular Emergency
- [Acute Conjunctivitis](https://pupillalab.com/repertoire/acute-conjunctivitis): Viral / Bacterial / Allergic / Hyperacute
- [Adie (Tonic) Pupil](https://pupillalab.com/repertoire/adie-tonic-pupil): Holmes-Adie Syndrome — Postganglionic Parasympathetic Denervation
- [Amaurosis Fugax / Transient Visual Loss](https://pupillalab.com/repertoire/amaurosis-fugax): Ocular TIA — Vascular Emergency
- [Angioid Streaks](https://pupillalab.com/repertoire/angioid-streaks): Bruch's Membrane Dehiscences — Systemic Associations
- [Anterior Uveitis](https://pupillalab.com/repertoire/anterior-uveitis): Iridocyclitis — HLA-B27 / Infectious / Idiopathic
- [Aphakic / Pseudophakic Bullous Keratopathy](https://pupillalab.com/repertoire/pseudophakic-bullous-keratopathy): Post-Cataract Surgery Endothelial Decompensation

## Optional

- [Full text of all guides and the FAQ, English and Arabic](https://pupillalab.com/llms-full.txt)
- [Arabic landing page](https://pupillalab.com/ar/)
- How to cite: Pupilla — Eye Exam Lab. Interactive eye exam simulator. https://pupillalab.com (accessed <date>).