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Signs
 
 

Absent Corneal Reflex

 
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Overview

  • How to Elicit

  • Lightly touch the cornea with a piece of cotton wool. Approach from the side so that the patient does not anticipate the stimulus.
  • Causes of Absent Corneal Reflex

  • Upper motor neuron lesion - pons or medullary infarction, tumour or haemorrhage
  • Facial nerve (VII) lesion - Bell’s palsy, infection, inflammation, tumour, trauma
  • Ophthalmic nerve (V1) lesion - trauma, tumour, ICA aneurysm, cavernous sinus thrombosis, SLE
  • Interpretation

  • No direct response - absent blink in the tested eyeIpsilateral facial nerve (VII) lesion
  • No consensual response - absent blink in the opposite eyeContralateral facial nerve (VII) lesion
  • No afferent response - absent blink in one eye when testing either eyeIpsilateral ophthalmic nerve (V1) lesion
  • No response - absent blink in both eyes when testing either eyePons or medullary lesion
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