Pupillary examination is a crucial test and need good judgment of observation because it is potential to reveal serious disease. Experts should do this procedure in a comprehension examination. Some important components of papillary testing are:
Observing the pupil shape, location and size of Pupillary Examination
On normal eyes, the pupil should be round, symmetrical and centered within the iris. If a patient has a non-round papillary shape it can be the result of posterior synechia from inflammation, surgical complication, or iris atrophy from age. Other abnormalities might be the displaced pupil (corectopia), white pupil (leukocoria), multiple pupil (polycoria), or the difference colors from both eyes (heterochromia). Under normal illumination, the size of adult’s pupil size ranges from 1.0 mm to 10 mm.
Pupillary reaction to light
On the normal condition, when light shone into one of the patients’ eyes, it will cause a direct response into the patients’ constrict. After that, it also will be followed by a consensual response from the other eye. The procedure is not just finished in the first trial. It needs to be done several times to observe the grading magnitude and the change of rapidity for perrla.
Swinging flashlight test
The goal of this test is to compare the strength of the direct pupillary and consensual response in the same eye. A normal condition should show the same result of both eyes and the same eyes in the matter of direct response and consensual response.
External Eye Examination
Many diseases are observable by doing the external eye examination. The external eye examination includes the eyelids, anterior chamber, lacrimal apparatus, conjunctiva and also cornea.
People with normal eyelid should have the eyelid cover the same amount of their eyeball. Some people whose nerves (precisely cranial nerves 3 and 7) responsible for controlling the structure is damaged, will have the upper lids on one side of his eyes appear lower than the other. It caused by the change in the autonomic nervous system.
See also Pupil Eye Assessment Chart
- Anterior chamber
A disease called rheumatoid arthritis or also known as the collagen disease could also infected this area. It decreases the mucus and tears production which makes the eye dry. These diseases are caused by viral, localized bacterial or fungus infection.
- Lacrimal apparatus
This part of the eyes produces the tears. As we know, tear is important to lubricate the eye. This part might be infected too by showing the inability to drain tears or it could also produce a chronically tearing eye.
Conjunctiva is the white part of the eyes. It is also the sensitive indicator of many ocular disease. On abnormal conjunctiva, the colour can be turned to yellow or bright red. The conjunctiva turns to red because of inflammation, some of the abnormality types caused by bacterial or viral infection.
The normal cornea is in the crystal clear form. An infected one will show a cloud like opacity. This can be caused of trauma, inflammation or the disorders in the blood vessels. This is the last matter that you should know about Important Matters of Pupillary Examination.