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Schematic diagram of pupillary light reflex neural pathway. Left direct light reflex involves neural segments 1, 5, and 7. Segment 1 is the afferent limb, which includes the retina and optic nerve. Segments 5 and 7 form the efferent limb. Left consensual light reflex involves neural segments 2, 4, and 7. Segment 2 is the afferent limb.
A consensual response is any reflex observed on one side of the body when the other side has been stimulated.. For example, if an individual's right eye is shielded from light, while light shines into the left eye, constriction of the right pupil will still occur (the consensual response), along with the left (the direct response).
In the swinging flashlight test, a light is alternately shone into the left and right eyes. A normal response would be equal constriction of both pupils, regardless of which eye the light is directed at. This indicates an intact direct and consensual pupillary light reflex. When the test is performed in an eye with an afferent pupillary defect ...
The pupillary reflex results in the pupil constricting (left) and dilating (right) These include the pupillary light reflex and accommodation reflex . Although the pupillary response , in which the pupil dilates or constricts due to light is not usually called a "reflex", it is still usually considered a part of this topic.
For an adequate test, vision must not be entirely lost. In dim room light, the examiner notes the size of the pupils. The patient is asked to gaze into the distance, and the examiner swings the beam of a penlight back and forth from one pupil to the other, and observes the size of pupils and reaction in the eye that is lit.
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Pupillary light reflex is tested by having the patient stare into the distance as the examiner shines the penlight obliquely into each pupil. Pupillary constriction is tested for on the eye examined (direct response) and on the opposite eye (consensual response). The swinging flashlight test involves