Abstract
Objective The authors compared two methods, the Marcus Gunn test and the alternating light test, for detecting a relative afferent pupillary defect. Design A randomized, prospective clinical trial. Participants Fourteen patients with unilateral optic neuropathy. Intervention The Marcus Gunn and alternating light tests were performed on each patient. Main outcome measures The results of the Marcus Gunn and alternating light tests for detecting a relative afferent pupillary defect on the affected side. Results The Marcus Gunn test was able to identify the affected eye in only 8 of 14 patients, whereas the alternating light test correctly identified the affected eye in 13 of 14 patients. Results of the Marcus Gunn test were indeterminate in 4 of 14 patients and were incorrect in 2 of 14 patients. Results of the alternating light test were indeterminate in one patient and never incorrectly identified the affected eye. Conclusion The alternating light test is superior to the Marcus Gunn test for detecting relative afferent pupillary defects.
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