The visual acuity does not necessarily correlate with an RAPD. Close this help box and click "It's off now". Although pupil testing provides gross observations in these areas, the slit lamp can be used to examine the pupil and iris in more detail. Possible diagnoses are Horner syndrome or simple anisocoria. This is so typical that an observant patient could provide the decisive diagnostic clue in a telephone conversation.
How to test for a relative afferent pupillary defect (RAPD)
In addition, the brightness of the light and its distance from the eye can affect the extent of constriction. Intraocular tumor - Retinal and choroidal tumors including melanoma, retinoblastoma, and metastatic lesion could lead to an RAPD if severe. In dim room light, the examiner notes the size of the pupils. Indication Anisocoria Unequal Pupil s. Search other sites for 'Pupillary Light Reflex'. A positive RAPD means there are differences between the two eyes in the afferent pathway due to retinal or optic nerve disease.
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J Neurol Neurosurg Psychiatry. There are certainly other causes of a relative afferent pupillary defect which I have omitted here. Prove del riflesso pupillare alla luce , Prova del riflesso pupillare alla luce. Thus, in a patient with a homonymous hemianopia from an optic tract disorder, an RAPD could be seen in the eye with the temporal visual field defect. This patient, only presenting with low-grade visual symptoms, was ultimately diagnosed with multiple sclerosis. Although these techniques have been shown to be effective and accurate, a number of factors influence the validity, variability, and reliability of such measurements. Conditions that have been associated with RAPD include glaucoma, macular degeneration, ischemic retinal disease, retinal detachment, vitreous hemorrhage, optic neuritis and radiation damage.
Many of these cases are benign in nature and occur most commonly in young females. The first author must also be the corresponding author of the comment. Ensure this occurs by sending the patient to the emergency department immediately and notify the hospital in advance of the incoming patient with the potential for a life-threatening condition. Before testing pupils, the patient should be instructed to remove her spectacle correction. The pupil response asymmetry also correlated with asymmetry in the visual field test or retinal nerve fiber layer thickness. Both of these responses indicate the integrity of the afferent pathway on the right side Figure 3. Frequently, tonic pupils are diagnosed behind the slit lamp.