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Assemble equipment: a pen torch and the patient’s observation chart (in some situations a neurological assessment chart).

Undertake pre-procedure checks (see above) to ascertain if there are any pre-existing irregularities with the patient’s eyes or factors that can influence pupillary assessment findings.

Explain the procedure to the patient, even if she or he is unconscious (Fig 1).Check if there are any pre-existing factors that can cause pupillary constriction, for example medications including narcotics and topical beta-blockers.Check if there are any pre-existing factors that can cause pupillary dilation, for example medications including tricyclics, atropine and sympathomimetics and traumatic mydriasis (Bersten et al, 2003).Note if the patient has any pre-existing irregularity with the pupils, for example cataracts, false eye or previous eye injury.Prior to undertaking pupillary assessment: Unreactive pupils can be caused by an expanding mass, for example a blood clot exerting pressure on the third cranial nerve a fixed and dilated pupil may be due to herniation of the medial temporal lobe. Both pupils should react equally to light. Pupil reaction should be documented as per local policy, for example B (brisk), S (sluggish) or N (no reaction). There should also be a consensual reaction to the light source, that is the opposite pupil also constricts when the light source is applied to one eye (Jevon, 2007). Pupil reaction to light should be brisk and after removal of the light source, the pupil should return to its original size. It should be round abnormal shapes may indicate cerebral damage oval shape could indicate intracranial hypertension (Fairley, 2005). The average size is 2-5mm (Bersten et al, 2003).

Pupil size should be measured, ideally with reference to a neurological observation chart or similar. Compression of this nerve will result in fixed dilated pupils (Fairley, 2005).Īny changes in the patient’s pupil reaction, size or shape, together with other neurological signs, are an indication of raised intracranial pressure (ICP) and compression of the optic nerve. If you notice any results that fall outside these standards, be sure to schedule an eye exam with your Vision Source doctor.Evaluation of pupillary reaction is effectively an assessment of the third cranial nerve (oculomotor nerve), which controls constriction of the pupil. Older children and adults should be able to read the majority of letters on the 20/20 line. A 3- to 4-year-old should be able to read the 20/40 line, and a 5-year-old the 20/30 line. That depends on the age of the person being tested.

Cover the other eye and repeat steps 5-7.

Write down the number of the smallest line where you identified the majority of letters correctly (Ex. If you were able to read 5 out of 8 letters on line 8, you would write 20/20.).

Continue to the bottom row or until you can no longer read the letters.

Have another person point to each line as you read the letters out loud and keep track of which letters you get right.

Cover one eye (if you wear glasses for distance vision, keep them on).

Tack or tape the chart to a windowless wall in a well-lit room at eye level.

Pupil chart free#

Print the free eye chart on regular 8 1/2 x 11-inch paper.

Pupil chart professional#

But it could help you identify potential vision problems that demand professional attention. Remember: This is not a substitute for a complete medical eye exam by a licensed optometrist. You can use this eye chart to check your entire family's vision.

Pupil chart download#

Simply click on the image to the right, and your download will begin. Searching for a free eye chart to check your vision at home? Free Eye Chart - Download, Print, and Test