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A relative afferent pupillary defect (RAPD), also known as a Marcus Gunn pupil (after Robert Marcus Gunn), is a medical sign observed during the swinging-flashlight test [1] whereupon the patient's pupils excessively dilate when a bright light is swung from the unaffected eye to the affected eye. The affected eye still senses the light and ...
When the optic nerve is damaged, the sensory (afferent) stimulus sent to the midbrain is reduced. The pupil, responding less vigorously, dilates from its prior constricted state when the light is moved away from the unaffected eye and towards the affected eye. This response is a relative afferent pupillary defect (or Marcus Gunn pupil). [1]
Marcus Gunn phenomenon is an autosomal dominant condition with incomplete penetrance, in which nursing infants will have rhythmic upward jerking of their upper eyelid. This condition is characterized as a synkinesis : when two or more muscles that are independently innervated have either simultaneous or coordinated movements.
To settle the question of whether the AR pupil is of central or peripheral origin, it will be necessary to perform iris transillumination (or a magnified slit-lamp examination) in a substantial number of patients who have a pupillary light-near dissociation (with and without tonicity of the near reaction), perhaps in many parts of the world.
This test detects the afferent pupil defect, also referred to as the Marcus Gunn pupil. It is conducted in a semidarkened room. In a normal reaction to the swinging-flashlight test, both pupils constrict when one is exposed to light. As the light is being moved from one eye to another, both eyes begin to dilate, but constrict again when light ...
Mandy Bardisbanian, 33, is one of only 300 people in the world with Marcus Gunn Jaw-winking syndrome - which has caused her to be bullied and self-harm. The rare genetic disorder means nerves and ...
For example, in a person with abnormal left direct reflex and abnormal right consensual reflex (with normal left consensual and normal right direct reflexes), which would produce a left Marcus Gunn pupil, or what is called left afferent pupillary defect, by physical examination. Location of the lesion can be deduced as follows:
Robert Marcus Gunn (1850, Dunnet – 29 November 1909, Hindhead) was a Scottish ophthalmologist remembered for Gunn's sign and the Marcus Gunn pupil. Early life and ...