Vision Screening Online Training Program - Pupillary Light Response

Vision Screening Online Training Program

Module 5 (continued): Pupillary Light Response
(C&TC: Often performed by the health care provider)

The pupillary light response is used to make sure a child's eyes respond appropriately to light. A failure of a pupil(s) to constrict or dilate quickly and/or equally may be due to lesions on the retina, ocular nerve damage, or even blindness and requires a referral to a health care provider.

Ages
Zero months through 20 years of age.

Purpose
To check for the pupils' reaction to changes in illumination.

Description
Pupillary light response is checked as a light is briefly flashed into the eye.

Equipment

  • Penlight.
  • Visual acuity chart at 10 feet from the child's eyes.

Note
This test should be performed AFTER the visual acuity test, as the bright light creates dark afterimages that may have a negative impact on the visual acuity test.

Facilities
Lower light level.

Screener qualifications
This test should be performed only by trained health care personnel, such as ophthalmic or optometric staff or nurses.

Procedure

  • Dim the room lights.
  • Instruct the child to look at the largest figure on the eye chart across the room or another large target that keeps the attention of the child away from the light.
  • Observe the size and shape of the pupils (they should be round and equal in size).
  • Turn on the penlight and shine it directly into the child's right eye at a distance of approximately 3 inches from the eye.
    Example shining a penlight directly into a child's eye from approximately 3 inche from the eye
  • Observe the pupil size quickly decrease (constrict) in both eyes.
    Example pupile size quickly decreasing in both eyes
  • Move the penlight away from the eyes.
  • Observe the increased size of both pupils (dilate) after the penlight is moved away.
  • Shine the penlight directly into the child's left eye at a distance of approximately 3 inches from the eye.
  • Observe the pupil size quickly decrease (constrict) in both eyes.
  • Shine the penlight into the right eye and observe the pupil size (it should stay small).
  • In a smooth motion, swing the penlight (still on) to the left eye and observe the pupil size (it should stay small).
  • Repeat the swinging motion between the two eyes 2 or 3 times.

PASS

  • Pupils dilate (get larger) when room light is dimmed.
  • Pupils are round and equal in size, in both bright and dim light.
  • Pupils quickly and symmetrically constrict to a bright light directed into either of the eyes and when the bright light swings between the two eyes.

REFER

  • Unequal or sluggish response to light.
  • Pupils unequal in size or not round.
    Pupils unequal in size or not round

Question

While performing the pupillary light response, as long as both pupils constrict in response to the light, it does not matter if one pupil is slower than the other pupil.
True
False



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