Pupil Evaluations Flashcards
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Pupils are measured on a scale from ____ with good constriction recorded as ___ and no pupillary reaction recorded as ____
Corectopia
A misplaced pupil
Anisocoria
Unequal pupil size
Miotic
Small, constricted pupil
Mydriatic
Drug classification that dilates to pupil
Direct light reflex
Constriction of the pupil to light as observed in the illuminated eye
Consensual light reflex
The constriction of the pupil to light as observed in the fellow eye
Sphincter muscle
One of the iris muscles responsible for constriction - parasympathetic
Dilator muscle
One of the iris muscles responsible for dilation- sympathetic
Accommodative/near reflex
The constriction of the pupil in response to accommodation of a near stimulus
Marcus Gunn reflex
Paradoxical dilation to a bright light, a sign of optic nerve disease (aka APD)
Optic nerve —> optic tract —> pretectal nucleus (midbrain) —> decussate —> Edinburgh Westphal nucleus —> cranial nerve 3 —> ciliary ganglion —>inferior CN 3 —> sphincter
What is the pupillary pathway?
Dilator muscle/sympathetic innervation
Increased anisocoria in dim light means one pupil cannot dilate hinting at a problem with ____
Sphincter muscle/parasympathetic
Increased anisocoria in bright light means one pupil cannot constrict, hinting at a problem with…
Near light dissociation
Pupil constricts at near but not to direct light (neurological— syphilis)
Amaurotic pupil
Manifested in an eye with no light perception
Argyll-Robertson pupil
“Prostitutes pupil” small, irregular pupils which do not react to light but have a positive accommodation response— cause is CNS syphilis or diabetes, alcoholism, mid-brain tumors
Aide’s Tonic Pupil
Benign pupil condition where affected pupil is dilated in bright illumination, shows no immediate response to bright light (slow constriction) and is unilateral presenting in the 3rd-5th decade of life in primarily females
Idiopathic and benign
Aide’s is not alarming because it is ____
Horner’s syndrome
Ptosis, meiosis, and anhydrosis on one side— pupil will not dilate quickly after bright light exposure— medically significant
Marcus-Gunn Pupil
Poorer direct that consensual pupil response, aka APD, sign of optic nerve dysfunction— diseased eye dilates upon light exposure
