What are the abnormalities of pupil?
Signs of pupil abnormalities
| Condition | Pupillary signs |
|---|---|
| Physiological anisocoria | Unequal pupil sizes ≥0.5mm but <1mm. Asymmetry similar in light and dark conditions |
| Tonic pupil | Affected pupil larger. Decreased response to light but normal near response |
| Horner’s syndrome | Miosis of affected pupil |
What causes pupillary defect?
ischemic optic disease or retinal disease. severe glaucoma causing trauma to optic nerve. direct optic nerve damage (trauma, radiation, tumor) retinal detachment.
What does a Marcus Gunn pupil indicate?
A Marcus Gunn pupil indicates an afferent defect, usually at the level of the retina or optic nerve. Moving a bright light from the unaffected eye to the affected eye would cause both eyes to dilate, because (more…)
What is sluggish pupil?
The affected (larger) pupil does not immediately respond to direct or consensual light reflex; however, if light stimulus is prolonged, this pupil will slowly constrict to light and slowly dilate in the dark. Accommodation in the affected pupil is sluggish. The other pupil is of normal size and reacts to light.
What is afferent pupillary defect?
Background. Relative Afferent Pupillary Defect (RAPD) is a condition in which pupils respond differently to light stimuli shone in one eye at a time due to unilateral or asymmetrical disease of the retina or optic nerve (only optic nerve disease occurs in front of the lateral geniculate body).
What causes afferent pupillary defect?
Causes of RAPDs Common causes of unilateral optic nerve disorders that can be associated with a RAPD include ischaemic optic neuropathy, optic neuritis, optic nerve compression (orbital tumours or dysthyroid eye disease), trauma, and asymmetric glaucoma.
What is efferent pupillary defect?
Efferent pupillary defects are caused by problems of sympathetic or parasympathetic innervation or structural iris changes presenting as anisocoria or impaired pupillary light reaction. This overview describes the diagnostic steps for evaluating efferent pupillary disorders and outlines further steps of work-up.
What is a positive RAPD?
A positive RAPD means there are differences between the two eyes in the afferent pathway due to retinal or optic nerve disease. If the light used is sufficiently bright, even a dense cataract or corneal scar will not give a RAPD as long as the retina and optic nerve are healthy.
What is scalloped pupil?
In addition, the irises have a characteristic uneven pattern known as “scalloping” at the inner (pupillary) edge. The pupils are enlarged (dilated) and are fixed, which means they do not get smaller (constrict) in response to light.
What is the difference between afferent and efferent pupillary defect?
Pupils: if the parasympathetic pathway for pupillary constriction is normal (efferent pathway), a decreased direct light reflex indicates anterior visual pathway (afferent pathway) disease. In other words a slowed or absent pupil response points to a disorder of the retina, optic nerve, chiasm, or anterior optic tract.
How do you test for afferent pupillary defect?
The ‘swinging light test’ is used to detect a relative afferent pupil defect (RAPD): a means of detecting differences between the two eyes in how they respond to a light shone in one eye at a time.