Schematic overview of the anatomy of the pupillary light reflex arc. The size of the pupils depends on the balance of parasympathetic and sympathetic activity. Pupil abnormalities pupil abnormality oph08 diplopia oph06 infant with strabismus oph09 sudden loss of vision and headache oph05 altered level of consciousness in an adult n04subtitle. Pupil abnormalities dr stephen best consultant ophthalmologist. Pupil diameter is subject to continuous variations as a function of changes in luminance, fixation and psychosensitive stimuli.
In optometry school, our professors often stress how important close observation of a patients pupils can be in assessing his or her ocular and systemic. Increasing brightness causes pupillary constriction while increasing darkness causes pupillary dilation. Case scenario links pupil abnormalities pupil abnormality oph08 diplopia oph06 infant with strabismus oph09 sudden loss of vision and headache oph05 altered level of consciousness in an adult n04subtitle. Pupil testing back to the basics optometrys meeting. The size of pupil normally varies between 2 to 4 mm. They constrict to direct illumination direct response and to illumination of the. Disorders of pupillary function, accommodation, and lacrimation. Abnormalities of eyelid position and function timothy j. Pupil anomalies and disorders shiva ppt linkedin slideshare. Pupillary abnormalities can be caused by a variety of conditions. The superficial location of the pupillary fibers in the third cranial nerve is frequently cited as being responsible for the usual pupillary dilation seen with.
Optom 6th batch institute of community ophthalmology, chittagong 2. The ciliospinal reflex pupillary skin reflex consists of dilation of the. Pupillary abnormalities pupillary disorders may involve the afferent pathways rapd or the efferent pathways. During sleep the pupils are partially constricted but still react to light.
To understand the relationship between pupil abnormalities and. Abnormal eyelid position and function can be caused by disorders involving the third. The pathway for pupillary constriction for each eye has an afferent limb taking sensory information to the midbrain. In the presence of a pupil which scarcely reacts to the direct light stimulus, the indirect or consensual reflex must be examined, by stimulating the contralateral eye. The pupil is abnormal if it fails to dilate to the dark or fails to constrict to light or.
The sympathetic pathway responsible for pupil dilation. Iris anomalies that may simulate neurologic pupillary abnormalities. If the smaller pupil is abnormal poor dilatation, the anisocoria is greatest in dark. Caused by disruption of parasympathetic pupillary pathway. By way of the optic tract the afferent path 1 of the pupil lary system projects to the dorsal. The resulting defect is called an afferent pupil defect if it affects the optic pathway fig 12. Pdf on oct 1, 2004, chris hodge and others published pupil disorder. Abnormal pupil responds to consensual light but not direct light. Pupil function and provides an overview of the clinical assessments that should be undertaken. This article will summarise the relevant anatomy and physiology of pupillary control, outline the pharmacological aspects of.
Pupillary dilatation is controlled by the sympathetic system and is efferent only. The ultimate guide to pupil abnormalities covalentcareers. Pdf abnormal pupillary light reflex with chromatic. Assessment and diagnosis tomy rm kerala j ophthalmol. Physiology and abnormalities of the pupil knowledge for. Pupillary size can vary in response to light intensity and neurologic stimuli. Disorders of pupillary structure and function neurologic clinics. Here is everything you need to know about abnormalities affecting the pupil.
Anisocoria, where not physiological, indicates a problem of the efferent pupillary pathway, either parasympathetic or sympathetic horners syndrome. Abnormal pupillary light reflex with chromatic pupillometry in gacher disease article pdf available february 2014 with 127 reads how we measure reads. Pupil it is a circular aperture at the centre of the iris that allows light to enter the retina. Pupillary assessment is an important part of neurological assessment.
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