Afferent Pupillary Defect

A 42-year-old white female was referred to our clinic by her optometrist for an evaluation of spasms of her right upper and lower eyelids. The patient reported that these spasms began within the last 2 years. They occur every day and are continuous throughout the day. The spasm would sometimes involve the ipsilateral cheek area. The patient did not recall any specific cause for the spasms, but the symptoms seemed to get worse throughout the day and with caffeine intake. She was uncertain whether the spasms persisted while asleep. She also reported increased light sensitivity. The patient denied any reduced hearing, vertigo or balance issues.

Most ophthalmic educators stress the importance of pupils — excluding relative afferent pupillary defect — along with careful assessment of disc borders and confrontation visual fields to rule out optic nerve and visual pathway disorders.

NEPTUNE, N.J. – All retinal ganglion cells are equally damaged in most retinal neuropathies, but a case presented here at the New Jersey Academy of Optometry continuing education event showed that these cells are preserved in Leber’s hereditary optic neuropathy.

LAS VEGAS – Evaluating the pupil is an often-neglected procedure, according to Mario Gutierrez, OD, here at Vision Expo West.