{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T03:09:20Z","timestamp":1791947360588,"version":"4.3.4"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurosci."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>It is known that illicit and prescribed drugs impact pupil size, eye movement and function. Still, comprehensive quantitative evaluations under known ambient light conditions are lacking, when smartphones are used for monitoring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this clinical study (NCT05731999), four medicinal products with addiction risks were administered to 48 subjects (18\u201370\u202fyears old, all with informed consent, 12 subjects per drug). Videos captured by smartphones at ~50 lux and\u202f~\u202f500 lux documented the eye\u2019s reaction before and after controlled intake of single doses of oral oxycodone (20\u202fmg), lorazepam (2\u202fmg), lisdexamphetamine (70\u202fmg) and inhaled cannabis flos (65\u202fmg with 22% THC) over a 5-h test period. Data from three observational tests, non-convergence (NC, ability to cross the eyes), nystagmus (NY), and pupillary light reflex (PLR) were converted into 24 key features that represent different eye characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the acquired data, 87\u201397% produced key features. At peak drug plasma concentration, oxycodone constricted pupils (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001); lorazepam induced non-convergence (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001); lisdexamphetamine induced dilated pupils (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), irrespective of ambient light conditions. Inhaled cannabis induced miosis (<jats:italic>p<\/jats:italic>\u202f=\u202f0.05 at ~50\u202flux, <jats:italic>p<\/jats:italic>\u202f=\u202f0.10 at ~500\u202flux), a reduced light-induced amplitude (<jats:italic>p<\/jats:italic>\u202f=\u202f0.003 at ~50 lux, <jats:italic>p<\/jats:italic>\u202f=\u202f0.3 at ~500 lux) and redness of the sclerae (<jats:italic>p<\/jats:italic>\u202f=\u202f0.14 at ~50 lux, <jats:italic>p<\/jats:italic>\u202f=\u202f0.007 at ~500 lux). The drug effect lasted at least 5\u202fh (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.005) except for inhaled cannabis (2\u20133\u202fh, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The ocular response to oxycodone, lorazepam, lisdexamphetamine and cannabis, as measured under controlled light conditions using a smartphone-based assessment, demonstrated distinct and readily distinguishable patterns for each substance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p>Identifier, NTC05731999.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnins.2024.1492246","type":"journal-article","created":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T12:52:42Z","timestamp":1736254362000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Eye reactions under the influence of drugs of abuse as measured by smartphones: a controlled clinical study in healthy volunteers"],"prefix":"10.3389","volume":"18","author":[{"given":"Kiki W. 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