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Pupillary Assessment

May 18, 2019

Measure

This section of the test is going to test your knowledge of pupil size. Two terms to know here are miotic and mydriatic.

Miotic pupils are smaller than 2mm.

Mydriatic is a pupil size larger than 6mm.

Memorization Trick:

Miotic is small like a tick. Mydriatic is big and dramatic.

Anisocoria is when the pupils are unequal sizes. This may happen after a traumatic incident.

Know the difference between direct pupillary response and consensual pupillary response.

Direct pupillary response– is when only one pupil responds to light

Consensual pupillary response – if one pupil reacts to light the other reacts also.

Argyll Robertson pupils – are pupils that have no direct or consensual response.This is also a sign for syphilis.

The acronym that was the most useful to me when learning how to evaluate pupils was PERRLA.

P-Pupils

E-Equal – Are the pupils the same size. Remember, anisocoria is when pupils are not equal. Unequal pupils can indicate stroke or trauma.

R-Round – Shape is important. Shape can be changed by surgery, trauma, or a birth defect.

R-Reactive (to)

L-light – Reaction to light is tested by Marcus Gunn aka APD(afferent pupillary defect)

A-Accommodate pupils change size when the look up close

NOTE: You may see the test talk about RAPD is the same as an APD which is also the same as a Marcus Gunn Pupil.