Pupil

Photomotor response—PMR direct is the miosis of the pupil of the illuminated eye and PMR indirect, consensual is miosis of the pupil in boths eyes illumination of one eye. PMR disruption by affecting the afferent pathway in relative afferent pupillary defect—RAPD—Marcus Gunn pupil. In severe retinal pathology with decrease in VA complet afferent pupillary defect is amaurotic pupil. PMR disruption by affecting the efferent pathway: sympathic damage—Claude Bernard Horner syndrome (ptosis, miosis, aparent, enophtalmia) and parasimpathetic damage in cranial nerve III palsy (mydriasis, cyclopegy, ptosis, paralitic strabismus, heteronymous diplopia) and Adie tonic pupil (the affected pupil in moderated dilated relative to the healthy pupil in medium illumination). Argyll Robertson syndrome in which the two pupils are small, and irregular, contract slowly, but strongly (punctiform in accomodation and convergence). PMR is absent but the convergence reflects is preserved. Is possible: disorders of pupilary statics (number, location, color, form), motor pupilary disorders (isocoria uni/bilateral, miosis unibilateral, midriasis uni/bilateral, paralytic spastic).