THEORY: Pupil Abnomalities
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Manifested in an eye with no light perception.
1. No direct response in "blind eye"
2. No consensual response in "good eye"
3. Direct response in "good eye"
4. Consensual response in "bad eye"
5. Positive APD in "blind eye"
1. Small (1-2mm) pupils, which do not react to light, but do have a positive accommodative response.
2. Main cause is CNS Syphilis, but also can be caused by diabetes, alcoholism, and mid-brain tumors.
1. A benign condition, where the affected pupil is dilated in bright illumination.
2. The pupil shows no immediate response to bright light, but may eventually show some constriction with sustained exposure.
3. This condition is usually unilateral, and begins during the 3rd to 5th decade in life.
4. Mostly females affected.
Aide's Tonic Pupil
1. Ptosis, miosis, and anyhydrosis on affected side.
2. A variety of vascular, traumatic, or neoplastic lesions interrupt the oculosympathetis pathway.
3. Pupil will not redilate quickly after bright light exposure.
1. Poorer direct response than consensual response in affected eye.
2. Sign of optic nerve disease.
3. If light is directed into the intact eye, miosis occurs because of the direct response and the consensual response in the other eye.
4. If light is directed into the diseased eye, it is like the patient going into a dark room.
5. The direct light response is less intense than the previous consensual response.
Marcus-Gunn pupil (APD)
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