Wednesday, April 24, 2013

Pupillary Light Reflex And Visual Field Defects

Two videos to understand the Pupillary Light Reflex and Visual Field Defects

Q1: Patient with large retinal detachment in the right eye. The retina in the left eye is normal. What will you see if the pupillary light reflex is tested by swinging a light source from the left eye to the right eye?
A1: This patient has a Marcus-Gunn pupil. When the light strikes the normal retina, both eyes constrict the pupils. In case of retinal detachment or optic neuritis, inadequate quantity of light stimulate the eye, leading a paradoxical dilation of pupils in order to absorb as much light as possible.

Q2: Patient 45 year-old-woman presents complaining when she lookk to the left, the right eye stops at the midline and the left eye shows horizontal nistagmus, but whe she looks to the right both eyes move normally. What is the cause of this finding?
A2: Lesion of the of the right MLF.

Q3: Patient with visual problems came to your office. When a light is shined in the right eye, there is no pupillary response in either eye. When the light is shined in the left eye, both pupillary response are present. Where is the lesion located?
A3: Lesion of right optic nerve (CN II).

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