Diagnostic Tests for Pupil symptoms

Diagnostic Test list for Pupil symptoms:

The list of diagnostic tests mentioned in various sources as used in the diagnosis of Pupil symptoms includes:

• Eye examination
  • Inspect the eye noting the nature of redness, if present. This will help delineate iritis and glaucoma which may cause pupil dilation
  • Examine the pupils for size, shape, equality and regularity
  • Test the light and accommodation reflexes of the pupils. Usually a light shone into the pupils will cause the pupil to constrict. Usually focusing from a far object to a near object will cause the pupil to constrict
  • Unilateral pupil dilation which is not reactive to light or accommodation (focusing on near object) would suggest oculomotor nerve (third cranial nerve) palsy due to a ruptured brain aneurysm or intracranial haematoma (brain blood clot). If a unilateral dilated pupil reacts to both light and accommodation, must consider a local eye condition such as iritis, glaucoma, anisocoria (a condition in which the two pupils are not of equal size) or irritation of the cervical sympathetic nerves. If a unilateral dilated pupil reacts to accommodation but not to light, must consider neurosyphilis. If a unilateral dilated pupil does not react to light or accommodation, must consider blindness due to optic nerve (second cranial nerve) lesions
  • Examine for signs of Horner's syndrome such as partial ptosis (dropping down of the eyelid), unilateral constricted pupil which does react normally to light, and a decrease of sweating over the involved eyebrow
  • Visual acuity (sight test). The presence of blindness with a dilated pupil would suggest an optic nerve lesion (second cranial nerve)
  • Visual field testing - Mapping the visual field defect can help determine the cause of pupil symptoms.
  • Ophthalmoscopy and slit lamp examination - to examine the optic nerve, macula and retina.
  • Test the movements of the eyes
  • Measure intraocular pressure (tonometry) - to detect glaucoma which may cause dilated pupils.
• Physical examination
  • Full neurological examination
  • Blood tests
  • Alcohol level
  • Syphilis serology
• Urine tests
  • Urine drug screen
• Radiological investigations
  • CT Brain and/or MRI Brain (if neurological abnormalities are present) to detect various causes of pupil dilation such as ruptured brain aneurysm, intracranial haematoma (brain blood clot), brain tumor or stroke
  • CT or MRI of brainstem to detect various causes of pupil constriction such as brain stem tumor, syringomyelia, brain stem abscess
  • Angiography may be needed to rule out brain aneurysm
• Spinal tap - may be necessary if suspect neurosyphilis, multiple sclerosis, encephalitis or meningitis which may cause pupil symptoms.

Home Diagnostic Testing

These home medical tests may be relevant to Pupil symptoms causes:

• Vision & Eye Health: Home Testing:
  • Home Eye Tests
  • Home Vision Tests

 » Next page: Glossary

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