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Fig. 5.1. Schematic overview of the anatomy of the pupillary light reflex arc. By way of the optic tract the afferent path (?) of the pupillary system projects to the dorsal midbrain (pretectum, 2). From there, the signal is carried to the Edinger-Westphal subnucleus in the nuclear complex of the oculomotor (third) cranial nerve. The oculomotor nerve innervates the ciliary ganglion (3), from which the short posterior ciliary nerves arise and enter the eye to innervate the pupillary sphincter (4). Not to be overlooked are afferents in this reflex system that arise in the visual cortex and project to the pretectal region, providing another input pathway that participates in the reflex process

Pholedrine 1% or tyramine 2.5% test

Physiologic anisocoria

Swinging flashlight test or comparison of direct vs consual responses

Better than the LR

As good as the LR

Better than the LR

As good as the LR

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