Ophthalmology Book

Anatomy

Corneal Disorders

Eyelid Disorders

Glaucoma

Lacrimal Disorders

Miscellaneous

Pediatrics

Pupil Disorders

Retinal Disorders

Sclera Disorders

Traumatic Injury

Vision Disorders

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Swinging Flashlight TestAka: Marcus Gunn Pupil

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  1. Indication
    1. Anisocoria (Unequal pupils)
  2. Technique
    1. Check left eye response (direct and consensual)
      1. Shine light on left eye and check left pupil reflex
      2. Shine light on right eye and check left pupil reflex
    2. Check right eye response (direct and consensual)
      1. Shine light on right eye and check right pupil reflex
      2. Shine light on left eye and check right pupil reflex
  3. Normal response
    1. Direct light reflex
      1. Pupil constricts to direct light
    2. Consensual light reflex
      1. Pupil constricts to light shining on opposite pupil
  4. Abnormal: Afferent lesion (Retina or Optic Nerve)
    1. Known as Marcus Gunn Pupil
    2. Intact consensual light reflex
    3. Paradoxical Pupil Dilation to direct light
      1. Occurs on moving light from opposite to affected eye
  5. Abnormal: Efferent lesion (CN 3 or pupillary muscle)
    1. Affected eye loses consensual and direct light reflex
    2. Unaffected eye maintains consensual and direct reflex

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