Abstract
PurposeTo demonstrate the accuracy of slit lamp assessment of relative afferent pupillary defect (RAPD) in patients with asymetric optic neuropathy.Methods40 eyes of 20 patients with asymetric optic neuropathy and no obvious RAPD in swinging flashlight test were evaluated on slit lamp. The asymetric optic neuropathy was confirmed by fundus examination, retinal nerve fiber layer thikness on OCT, visual field examination, visual potentials and/or brain and orbit MRI.The horizontal pupillary diameter in the affected (or more affeted) eye was measured and compared to the horizontal pupillary diameter of the fellow eye using the width of the slit lamp beam. Both diameters were measured in millimeters and compared.ResultsThere was a quantified anisocoria and RAPD each time when asymetric optic neuropathy was present. In other words, with the same slit lamp beam width (the same light intensity) the affected (or more affected eye) had a larger pupillary horizontal diameter.ConclusionsSlit lamp assessment of RAPD is simpler, quicker and more accurate than standard assessment using swinging flashlight test especially when anisocoria is not obvious.
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