Overview
This lecture explains how to assess pupil responses using a pen light during a neurological assessment in nursing, covering correct technique and documentation.
Equipment and Preparation
- Use a pen light with a pupil size gauge for accurate measurement.
- Dim the room before assessing pupil reflexes for better observation.
Normal Pupil Characteristics
- Normal pupil size ranges from 3 to 5 mm.
- Pupils should be round and equal in size.
Assessing Pupil Responses
- Shine the pen light into one eye to check for a direct response (pupil constricts to light).
- Observe the opposite eye for a consensual response (both pupils constrict together).
- Perform the swinging light test by moving the pen light between eyes every 2–3 seconds, observing response.
Accommodation Test
- Ask the patient to focus on an object held at a distance, then move it slowly closer to their face.
- Watch for both pupils constricting as the object moves closer (accommodating response).
Documentation
- Document findings as PERRLA: Pupils Equal, Round, Reactive to Light, and Accommodating.
Key Terms & Definitions
- Direct response — Pupil constriction in the illuminated eye.
- Consensual response — Simultaneous constriction of both pupils when one is illuminated.
- Accommodation response — Pupils constrict when focusing on a near object.
- PERRLA — Pupils Equal, Round, Reactive to Light, and Accommodating.
Action Items / Next Steps
- Practice assessing pupil responses using a pen light on a peer or mannequin.
- Document pupil assessments using PERRLA in patient records.