Instructions on how to perform the swinging light test to detect a relative afferent pupillary defect. http://www.cmaj.ca/content/early/20 Normal swinging light test Left relative afferent pupillary defect* (RAPD) 1. Begin with dark room, bright pen light and patient fixated at distant object (to avoid a near pupil response). 2. Shine light into right (R) eye. Both pupils should constrict. 3. Swing light to left (L) eye. Both pupils remain constricted. 4. Swing light back to right eye. Both pupils remain constricted. Left relative afferent pupillary defect* (RAPD) 1. Begin with dark room, bright pen light and patient xated at distant object. 2. Shine light into right (R) eye. Both pupils should constrict. 3. Swing light to left (L) affected eye. Instead of pupil constriction, both pupils will dilate. 4. Swing light back to right (normal) eye. Both pupils constrict. Instructions on how to perform the swinging light test to detect a relative afferent pupillary defect. #Diagnosis #PhysicalExam #Ophthalmology #RAPD #Relative #Afferent #Pupillary #Defect #Swinging #Light #Test #Instructions
