![]() ![]() Optic nerve tumor: This includes primary tumors of the optic nerve (glioma, meningioma) or tumors compressing the optic nerve ( sphenoid wing meningioma, pituitary lesions, etc.).Hereditary optic neuropathies, such as Leber's optic neuropathy (usually eventually bilateral) and other inheritable optic neuropathies.Other optic nerve infections : cat scratch disease, syphilis, Lyme disease, toxoplasmosis, cytomegalovirus, cryptococcus and TB, etc.Other optic nerve inflammations Sarcoidosis, systemic lupus erythematosus, Sjögren’s syndrome.Glaucoma: While glaucoma normally is a bilateral disease, if one optic nerve has particularly severe damage, an RAPD can be seen however it can cause bilateral APD.Ischemic optic neuropathies: These include arteritic ( Giant Cell Arteritis) and non-arteritic causes.Even mild optic neuritis with a minimal loss of vision or normal vision can lead to RAPD. Demyelination Optic neuritis: Multiple sclerosis, Neuromyelitis Optica Spectrum Disorder, Anti-MOG etc.Common causes of unilateral optic neuropathies that lead to RAPD are: Īny disorders that affect the optic nerves regardless of the its pathology can lead to a RAPD. The results of this simple yet very important test help doctors in early diagnosis of many important eye related diseases such as optic neuropathy and multiple sclerosis. ![]() off note if the condition is bilateral and symmetrical, there will not be a RAPD but bilateral APD. In case if both pupils do not show a similar response to the light stimuli, shone in one eye at a time, the patient will be diagnosed with RAPD or Marcus Gunn pupils. The doctor will ask the patient to look ahead then shines a penlight first toward one eye, then swing to the other, alternating quickly to observe patient’s pupils’ response to the light. Swinging flashlight test or Marcus Gunn test is one of the most basic eye exams that neurologists, ophthalmologists, optometrists and other physicians perform when visiting most of their patients. Relative Afferent Pupillary Defect (RAPD) is a condition in which pupils respond differently to light stimuli shone in one eye at a time due to unilateral or asymmetrical disease of the retina or optic nerve (only optic nerve disease occurs in front of the lateral geniculate body). 5 Digital Marcus Gunn Test as an Alternative Solution.3 RAPD Diagnosis and Challenges with the Swinging Flashlight Test.2.2 Other Causes of a Relative Afferent Pupillary Defect.2.1 Retinal Causes of a Relative Afferent Pupillary Defect. ![]()
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