Shining light in the relatively normal eye causes both pupils to constrict. There is no anisocoria associated with an RAPD because both pupils dilate equally when light is shined in the abnormal eye. This finding indicates that the signal going back to the midbrain is unequal between the two eyes. A neutral density bar can be used to determine the severity of an RAPD. Watching how quickly the pupils redilate during the swinging flashlight test helps to differentiate a subtle RAPD from hippus, which should be symmetric movement between the two eyes.įig. If one pupil starts to dilate at two and the other pupil starts to dilate at three, this is an RAPD. Watch to see at which number the pupils start to dilate. While alternating the light, count to three. While doing this, look for anisocoria in bright illumination.įinally, check for a relative afferent pupillary defect (RAPD) by moving the light back and forth between both eyes (swinging flashlight test). Then use the transilluminator to check pupillary light reactions. This will allow you to see the pupils in dim illumination without getting too much light getting in the way. Look for anisocoria in dim illumination by holding the light two to three inches below the chin and shining the transilluminator upward, tangential to the patient’s face. The patient should fixate on a distant target to prevent the pupil constriction that occurs with accommodation and convergence. The contrast of the lack of room light compared with the brightness of the transilluminator will accentuate a relative afferent pupillary defect. Most importantly, we will cover the characteristics of five pupil disorders that should be managed emergently.Ĭheck pupil sizes and reactions with the room lights off in order to make the room as dark as possible. The following article will cover how to evaluate the pupils and ways to identify and localize both afferent and efferent pupillary disorders. In addition, almost all of the true emergent conditions we deal with in optometry can be picked up by a pupil examination. With one quick, objective test, the pupil evaluation provides information about the retina, optic nerve, chiasm, optic tract, midbrain, cranial nerves III and V and the orbit. U nderstanding pupil testing and disorders is critical. Shining light in the right eye causes both pupils to dilate. Shining light in the left eye causes both pupils to constrict. A right RAPD in a patient with optic neuritis. The Review Education Group planners, managers and editorial staff have nothing to disclose.įig. Managers and Editorial Staff: The PIM planners and managers have nothing to disclose. Goodwin has no relevant financial interests to disclose. Those involved reported the following relevant financial relationships with ineligible entities related to the educational content of this CE activity: Author: Dr. PIM is committed to providing its learners with high-quality, accredited CE activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company. All identified conflicts of interest are thoroughly vetted and mitigated according to PIM policy. Check with your local state licensing board to see if this counts toward your CE requirement for relicensure.ĭisclosure Statements: PIM requires faculty, planners and others in control of educational content to disclose all their financial relationships with ineligible companies. Reviewed by: Salus University, Elkins Park, PAįaculty/Editorial Board: Denise Goodwin, ODĬredit Statement: This course is COPE approved for 2 hours of CE credit. PIM is accredited by COPE to provide CE to optometrists. PIM is jointly accredited by the Accreditation Council for Continuing Medical Education, the Accreditation Council for Pharmacy Education and the American Nurses Credentialing Center to provide CE for the healthcare team. Īccreditation Statement: I n support of improving patient care, this activity has been planned and implemented by PIM and the Review Education Group. Target Audience: This activity is intended for optometrists engaged in pupil disorder management. Manage patients with pupil abnormalities. Identify when additional tests and/or monitoring are required. Recognize the pathophysiology of pupil abnormalities.Ĭreate a work-up for the abnormal pupil patient. Jointly provided by Postgraduate Institute for Medicine (PIM) and Review Education GroupĮducational Objectives: After completing this activity, the participant should be better able to: Evaluation and Diagnosis of Pupil Disordersįollow this hands-on approach and learn from an expertĮstimated Time to Complete Activity: 2 hours
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |