Monday, February 21, 2011

Signs of Nerve Damage Seen in the Pupils of the Eyes

One test which my neurologist, opthalmologist, and primary care doctor each conduct during every office visit is the “swinging flashlight test.”  You know the one.  The doctor asks you to look ahead then shines a penlight first toward one eye, then the other, alternating quickly to observe your pupils’ response to light.

I strangely enjoy this test because I know that my pupils will show something unique.  Something which proves that I have damage to my optic nerve.  My pupils show a Relative Afferent Pupillary Defect (RAPD) or Marcus Gunn Sign.

What does the doctor look for during the “swinging light test”?

The pupils (the black centers of the eyes which dilate or constrict in response to light) are inspected for size, equality, and regularity.  Did you know that the pupils will constrict or dilate when you look at objects far or near?  They do, which is kinda cool.

More importantly, each pupil should constrict quickly and equally during exposure to direct light and to light directed at the other pupil (the consensual light reflex).   Using the swinging light test, the doctor can test and observe the pupillary response to consensual light in order to determine if there is a defect present.

Normally, the pupil constriction does not change as the light is swung from eye to eye.  When the light is moved quickly from eye to eye, both pupils should hold their degree of constriction.

Read this post in its entirety:

MS Signs vs. Symptoms: What is a Marcus Gunn Pupil?


  1. This is not the greatest thing to have discovered at a teaching hospital as all the young docs want a try to see how the pupils react...duhhh!

  2. Yeah! a feed summary ... off to go read the rest of the story.

  3. LOL. I can imagine the gathering team of students at the teaching hospital. "Look at this kids, watch how the pupils get bigger."

    I have a related story I should tell one of these days. :)