![]() There are different levels of severity - or types - of relative afferent pupillary defect. SEE RELATED: Polycoria: Causes, symptoms and treatment Types of relative afferent pupillary defect The eye with the smaller pupil will sense less light and display a decreased consensual pupillary response. The eye with the cataract will create an increased consensual pupillary response.Īnisocoria – One pupil is a different size than the other. Amblyopia, also called lazy eye, usually causes a very small RAPD or none.Ĭataracts – Clouding of the eye’s lens. Pretectum lesions – Damage to the pretectum (involved in visuomotor behaviors) due to abscess, wound or tumor.Īmblyopia – A disorder in eye development resulting in one eye that fails to reach normal visual acuity. Optic tract issues – Damage, injury or inflammation to the optic tract (the part that relays information to the visual cortex of the brain). Optic chiasm lesions – Damage to the optic chiasm (where the optic nerves cross paths in the brain) due to abscess, wound or tumor. Optic nerve trauma – When an injury to the eye, the bones surrounding the eye or the head leads to optic nerve damage. Glaucoma – When pressure within the eye becomes too high and begins pressing against the optic nerve. Ischemic optic neuropathy – A problem with the circulation of blood through the optic nerve Optic neuritis – Inflammation of the optic nerve. ![]() Macular disease or scarring – This can cause an RAPD only when there is extensive damage to this part of the eye (the macula). Retinal dystrophies such as retinitis pigmentosa – A group of conditions that cause the retina to degenerate progressively over time. Retinal scarring from trauma, infection or inflammation.Įndophthalmitis – Infection and inflammation of the contents of the eye. ![]() Retinal detachment – When a portion of the retina detaches from the back of the eyeball.Ĭentral retinal vein occlusion – When a blood clot blocks blood from leaving the retina.Ĭentral retinal artery occlusion – When a blood clot blocks blood flow into the retina. There are also other, less common causes. Relative afferent pupillary defect is usually caused by a problem in the retina (the light-sensitive tissue at the back of the eye) or the optic nerve (the connection that takes the light signal from the eye to the brain). Causes of relative afferent pupillary defect If undiagnosed, these underlying causes may lead to permanent vision damage or even loss of life. While RAPD on its own is not dangerous, it is often a sign of a serious disorder of the retina, optic nerve or brain. It requires testing by a trained professional such as an ophthalmologist, optometrist or neurologist. ![]() Because patients with a Marcus Gunn pupil do not have unequal pupils, it is not easily noticed. People with Marcus Gunn pupil have one eye that activates the consensual light reflex, but the other eye does not. This action is called the consensual light reflex. Both pupils constrict together when light is sensed - even if it’s only sensed in one eye. In healthy eyes, pupils constrict (get smaller) in bright conditions and dilate (get bigger) in dark conditions. It is also called Marcus Gunn syndrome or relative afferent pupillary defect (RAPD). Marcus Gunn pupil is a rare condition in which a person’s pupil does not respond to light correctly in one eye.
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