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Relative Afferent Pupillary Defect



  • The swinging eye test is used to assess for a relative afferent pupillary defect (RAPD), a sign of an asymmetric pathology affecting the pupillary reflex pathway.
    • How to Elicit

    • Shine a light into one eye, swing it into the other eye, and so on back and forth.
    • Interpretation

    • An RAPD is present if the affected eye dilates, or constricts briefly followed by dilatation.
    • Causes of Relative Afferent Pupillary Defect

    • Intraocular haemorrhage
    • Retinal detachment
    • Optic or oculomotor nerve lesion
    • Midbrain lesion
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