A 48 year old diabetic patient comes to OPD for check up, during the neurological examination – to check retinopathy, doctor checked the light reflexes – On flashing light in front of Left eye – Right pupil constricts but no effect on left, but on flashing ight in front of right eye- right pupil constricts but no effect on left. which of the following defect is present ?
Correct Answer: Efferent pupillary defect of left eye
Description: Efferent pupillary defect A lesion occurs in the oculomotor nerve's pupilloconstrictor nerve fibers. Results in dilation of the ipsilateral pupil (Due to unattended effect of the intact sympathetic supply). There will be failure of constriction of the pupil to light, light reflex will be preserved in the other eye. Light shone into the contralateral eye will elicit a normal direct response. Afferent pupillary defect Failure of constriction of either pupil to light shone into the affected eye If the visual system is normal in one eye, light shone will produce a normal direct pupillary reponse and also a consensual in the other eye.
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