![]() This abnormal response is also known as a Marcus Gunn pupil. This means that the afferent signal from this eye is weaker so that both its constriction and also the consensual reflex are reduced. If an RAPD is present then when light is shone on to the abnormal pupil, both pupils appear to dilate because the degree of constriction reduces.When the beam is swung from eye to eye, the bilateral pupil constriction should not change and both pupils should hold their degree of constriction. Note the pupillary constriction of both eyes.Check the light reflex in each eye, then move the beam swiftly and rhythmically from eye to eye, making sure that each eye receives the same light exposure, from the same angle. It relies on a comparison between the two eyes, and is looking for (and can only detect) an asymmetrical abnormality in the afferent pathway. This compares the direct and consensual pupillary constriction of each eye to look for a difference in the afferent conduction between them, called a relative afferent pupillary defect (RAPD). A normal result is a brisk, simultaneous, equal response of both pupils in response to light shone in to one or the other eye. ![]() Note whether there is a direct pupillary response (the pupil constricts when the light is shone on to it) and a consensual response (the other pupil also constricts). Illuminate the right eye from the right side and the left from the left side.
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