We performed infrared pupillography on 10 patients with familial dysautonomia. Pupillary constriction to light and accommodation was normal. There was no evidence for light-near dissociation, and tonic responses were not observed. Dilatation in darkness was normal. Ocular application of dilute pilocarpine produced miosis in all patients. Supersensitivity of the pupil to muscarinic agents in familial dysautonomia is unlikely to be explained by parasympathetic denervation. Possible explanations for this phenomenon include diminished lacrimation and corneal ulcerations.