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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).
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. Adjustment to close-range vision is known as "the near response", while relaxation of the ciliary muscle ...
Pupillary constriction is tested for on the eye examined (direct response) and on the opposite eye (consensual response). The swinging flashlight test involves moving the light between the two pupils. Normally both direct and consensual responses are elicited when the light shines on an eye, and some dilation will occur during the swing between.
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, light directed in the affected eye will cause only mild constriction of both pupils (due to ...
Pupillary response is a physiological response that varies the size of the pupil, via the optic and oculomotor cranial nerve. A constriction response ( miosis ), [ 1 ] is the narrowing of the pupil, which may be caused by scleral buckles or drugs such as opiates / opioids or anti-hypertension medications.
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.
The two different types of near response are caused by different underlying disease processes. Adie's pupil is caused by damage to peripheral pathways to the pupil (parasympathetic neurons in the ciliary ganglion that cause pupillary constriction to bright light and with near vision). The pathophysiologic mechanism which produces an Argyll ...