Relative afferent pupillary defect Differential diagnosis of relative afferent pupillary defect / causes of relative afferent pupillary defect are : -optic nerve compression
We describe a patient with a left trochlear nerve paresis and a left relative afferent pupillary defect despite normal visual acuity, color vision, visual fields, and fundus examination. Magnetic resonance imaging revealed a lesion in the right dorsal midbrain extending from the brachium of the supe …
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The swinging light test is used to detect a relative afferent pupil defect (RAPD): a means of detecting differences between the two eyes in how they respond to a light shone in one eye at a time. The test can be very useful for detecting unilateral or asymmetrical disease of the retina or optic nerve (but only optic nerve disease that occurs in front of the optic chiasm).
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On clinical examination, the patient had mild edema and ecchymosis of the left upper eyelid, mild proptosis of the left eye, a small subconjunctival hemorrhage in the temporal conjunctiva, and commotio retinae in his left macula. Ishihara color plates were full in both eyes. There was no resistance to retropulsion and no relative afferent pupillary defect. He was given oral antibiotics and a three-day course of oral steroids. He was followed closely and 1 week later referred to the oculoplastic surgery service for evaluation of the orbital foreign body. At the time of this evaluation (Figure 1), his visual acuity in the left eye had decreased to 20/40, and he had developed a mild left afferent pupillary defect. In addition, there was restriction of gaze to the extreme right secondary to pain ...
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Multiple sclerosis can sometimes cause the impairment of the pupil reflex known as a relative afferent pupillary defect (RAPD), or Marcus Gunn pupil.
Chronic relapsing inflammatory optic neuropathy (CRION), sometimes called chronic relapsing inflammatory optic neuritis, is a form of recurrent optic neuritis that is steroid responsive. Patients typically present with pain associated with visual loss. CRION is a diagnosis of exclusion, and other demyelinating, autoimmune, and systemic causes should be ruled out. Early recognition is crucial given risks for severe visual loss and because it is treatable with immunosuppressive treatment such as steroids. Relapse that occurs after reducing or stopping steroids is a characteristic feature Pain, visual loss, relapse, and steroid response are typical of CRION. Ocular pain is typical, although there are some cases with no reported pain. Bilateral severe visual loss (simultaneous or sequential) usually occurs, but there are reports of unilateral visual loss. Patients can have an associated relative afferent pupillary defect. CRION is associated with at least one relapse, and up to 18 relapses have been ...
On initial examination, the patients best-corrected visual acuity was 20/100 in the right eye and 20/70 in the left eye. The pupils were symmetrically 3 mm in diameter and poorly responsive to light in both eyes, with no evidence of a relative afferent pupillary defect. Intraocular pressure was recorded as 16 mm Hg in each eye. Slit-lamp biomicroscopy was unremarkable. Dilated fundus examination revealed marked optic nerve head swelling suggestive of papilledema and tortuous and dilated retinal venules (Figure 1A ...
A patient presents with unilateral visual loss with a relative afferent pupillary defect, pericentral scotoma, and sectoral retinal pigmented epithelial atrophy
A Relative Afferent Pupillary Defect is an examination finding in patients who have an asymmetric pupillary reaction to light when it is shined back and forth between the two eyes. It is most commonly a sign of asymmetric optic nerve disease or damage but can also present in widespread asymmetric r ...
This lecture will cover the pupillary examination, relative afferent pupillary defect, and the differential diagnosis of anisocoria. Videos will be used to illustrate all pertinent pupillary abnormalities. Lecturer: Dr. Karl Golnik Transcript (To translate please select your language to the right of this page) DR KARL GOLNIK: Todays topic is on pertinent pupillary problems. And I…
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