Walsh & Hoyt: Afferent Abnormalities

Afferent abnormalities. Relative afferent pupillary defect. The relative afferent pupillary defect (RAPD) is one of the most important objective signs of dysfunction in the afferent visual pathway. The methods of RAPD detection and quantification were reviewed in Chapter 15. In this section, we discuss the various conditions that should be considered when one finds an RAPD. Optic nerve disorders. Retinal disease. Induced RAPD from asymmetric retinal adaptation. Amblyopia. Local anesthesia and RAPD. Media opacities. Optic tract disorders. Pretectal nucleus. Geniculate and retrogeniculate lesions. Nonorganic visual loss. RAPD in normal eyes. Wernicke pupil. Poorly reacting pupils from midbrain disease. Paradoxical reaction of the pupils to light and darkness.