Head-To-Toe Assessment (I. Pupils)

Examination of the pupils involves several inspections, including assessment of the size, shape reaction to light is directed is observed for direct response of constriction. Simultaneously, the other eye is observed for consensual response of constriction.

The test for papillary accommodation is the examination for the change in papillary size as the is switched from a distant to a near object.

1.    Ask the client to stare at the objects across room.
2.    Then ask the client to fix his gaze on the examiner’s index fingers, which is placed 5 – 5 inches from the client’s nose.
3.    Visualization of distant objects normally causes papillary dilation and visualization of nearer objects causes papillary constriction and convergence of the eye.

Normal Findings:

·    Pupillary size ranges from 3 – 7 mm, and are equal in size.
·    Equally round.
·    Constrict briskly/sluggishly when light is directed to the eye, both directly and consensual.
·    Pupils dilate when looking at distant objects, and constrict when looking at nearer objects.

If all of which are met, we document the findings using the notation PERRLA, pupils equally round, reactive to light, and accommodate

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