3.1.9 Assesses Pupil Reactions

Question 1

How to assess pupils

Answer 1

• dim lights but not off
• direct and consensual
• swinging FL test

Question 2

What are afferent neurons

Answer 2

Sensory neurons that carry nerve impulses from sensory stimuli towards the central nervous system and brain

Question 3

Causes of RAPD

Answer 3

• optic nerve ischemia, compression, optic neuritis, aysymetric glaucoma
• large RD
• CRAO or ischemic CRVO

Question 4

What is physiological anisocoria

Answer 4

No underlying cause increased prevalence with age
Constant difference between light and dark

Question 5

What is adies pupil

Answer 5

• no underlying cause usually. Can be caused by infection, trauma or surgery
• caused by parasympathetic denervaton

Symptoms
- sudden blurred vision
- photophobia

Signs
- pupil may become smaller with time
- may be oval shaped or have segmental constriction
- unilateral
- affected pupil doesn’t construct much

Question 6

What is horners syndrome

Answer 6

• caused by interruption of the oculosympathetic innervation at any point along the neural pathway
• can be caused by neuroplasia, demyelination, carotid artery disease

Signs
- 1. Miosis 2. Ptosis 3. Anhydrosis
- mild ptosis due to weak mullers muscle
- elevation of lower lid due to weakness of inferior tarsal muscle
- dilation lag of miosed pupil
- reduced iop on affected side
- pupil responses normal just lagged

Question 7

Argyll-Robertson pupil

Answer 7

• bilateral miosis
• minimal or no light but normal near response

Caused by neurosyphalis