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Light reflexes

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To test the light reflexes, both direct and consensual:

  • use a pen torch
  • shine light into pupil from side - this is so that the patient does not focus on the light and accommodate
  • inspect both pupils
  • repeat the procedure - moving the torch in an arc from pupil to pupil
  • look for: - direct response to light - a normal pupil should constrict briskly when a light is shone into it - indirect - consensual - response to light - the pupil that is not having light shone directly into it should simultaneously constrict when its partner is stimulated in the manner; if this occurs, then it shows that the afferent pathway is intact - Marcus Gunn phenomenon - this is paradoxical dilatation of the abnormal pupil a short time after illumination has passed over to it from the normal eye

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