Reflexes 1

A common method involves using a penlight to observe the pupils’ reaction to light and to see if the pupil constricts and dilates normally. The reaction of the pupil to both direct and indirect (consensual) bright light and accommodation should be assessed and recorded. [16]

A non-reactive or fixed pupil may indicate a neurological emergency. A pupil that is slow or fails to react to light, but reacts to accommodation, is commonly due to one or other of:

• Optic neuropathy
• Holmes-Adie syndrome
• Argyll-Robertson pupil

No reaction to light or accommodation is most likely due to either oculomotor nerve palsy, or the use of a mydriatic drug. [16]