{"id":13478,"date":"2025-03-10T10:49:41","date_gmt":"2025-03-10T14:49:41","guid":{"rendered":"https:\/\/www.eyebuydirect.com\/blog\/?p=13478"},"modified":"2025-03-10T10:49:41","modified_gmt":"2025-03-10T14:49:41","slug":"what-is-perrla-eye-exam","status":"publish","type":"post","link":"https:\/\/www.eyebuydirect.com\/blog\/what-is-perrla-eye-exam\/","title":{"rendered":"PERRLA Eye Exam"},"content":{"rendered":"<p><strong>By <a href=\"https:\/\/www.eyebuydirect.com\/eyecare\/our-vision-experts\/thomas-stokkermans\">Thomas Stokkermans OD, PhD<\/a><\/strong><\/p>\n<h2><span class=\"TextRun SCXW243347286 BCX0\" lang=\"EN\" xml:lang=\"EN\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW243347286 BCX0\" data-ccp-parastyle=\"heading 2\">What Is a PERRLA Eye Exam?<\/span><\/span><\/h2>\n<p><span class=\"TextRun SCXW45209924 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun CommentStart CommentHighlightPipeRestRefresh CommentHighlightRest SCXW45209924 BCX0\">A PERRLA eye exam evaluates the size, shape, and responsiveness of the eye&#8217;s pupils. It is part of a comprehensive eye exam and is <\/span><span class=\"NormalTextRun CommentHighlightRest SCXW45209924 BCX0\">generally done<\/span><span class=\"NormalTextRun CommentHighlightRest SCXW45209924 BCX0\"> at the beginning. The results can help diagnose eye and nervous system disorders.<\/span><\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-13488 aligncenter\" src=\"https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-33.jpg\" alt=\"A closeup of an eye with colorful pupils\" width=\"900\" height=\"700\" srcset=\"https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-33.jpg 900w, https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-33-300x233.jpg 300w, https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-33-768x597.jpg 768w, https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-33-669x520.jpg 669w, https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-33-321x250.jpg 321w\" sizes=\"auto, (max-width: 900px) 100vw, 900px\" \/><\/p>\n<h2><span class=\"TextRun SCXW6690592 BCX0\" lang=\"EN\" xml:lang=\"EN\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW6690592 BCX0\" data-ccp-parastyle=\"heading 2\">What Does PERRLA Stand For?<\/span><\/span><\/h2>\n<p><span data-contrast=\"auto\">PERRLA is an acronym that stands for <\/span><b><span data-contrast=\"auto\">P<\/span><\/b><span data-contrast=\"auto\">upils <\/span><b><span data-contrast=\"auto\">E<\/span><\/b><span data-contrast=\"auto\">qual, <\/span><b><span data-contrast=\"auto\">R<\/span><\/b><span data-contrast=\"auto\">ound, and <\/span><b><span data-contrast=\"auto\">R<\/span><\/b><span data-contrast=\"auto\">eactive to <\/span><b><span data-contrast=\"auto\">L<\/span><\/b><span data-contrast=\"auto\">ight and <\/span><b><span data-contrast=\"auto\">A<\/span><\/b><span data-contrast=\"auto\">ccommodation. It describes the normal findings when shining a light at the eye:<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"2\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">Pupils are equal in size and have a round shape.<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"2\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"auto\">When a light shines in one eye, both pupils become smaller.<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"\" data-listid=\"2\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"auto\">The pupil response should be equally strong when shining a light on one eye compared to the other.<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"\" data-listid=\"2\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"auto\">The pupils shrink while looking at an object up close.<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"auto\">Any variation in these responses could mean a serious and, in some cases, life-threatening health condition.<\/span><\/p>\n<p>&nbsp;<\/p>\n<h2><span class=\"TextRun SCXW61542678 BCX0\" lang=\"EN\" xml:lang=\"EN\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW61542678 BCX0\" data-ccp-parastyle=\"heading 2\">How Is the PERRLA Eye Exam Done?<\/span><\/span><\/h2>\n<p><span data-contrast=\"auto\">The PERRLA eye test is done in a room with adjustable lights, a pen or flashlight, and a near target with something your eyes can focus on. It includes the following steps:<\/span><\/p>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"4\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">Both your pupils will be observed in bright and dim light to see if they are round and the same size.<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"\" data-listid=\"4\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"auto\">In a dim room, a light is shone into each eye to observe whether the pupil receiving the light constricts. Then, the other pupil is observed to constrict the same amount. This is called the <\/span><b><span data-contrast=\"auto\">direct and consensual response<\/span><\/b><span data-contrast=\"auto\">.<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"\" data-listid=\"4\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"auto\">Next, a light is moved back and forth between the eyes. It is pointed at one pupil for about two seconds and then moved quickly to the other eye.\u00a0 This is called the <\/span><b><span data-contrast=\"auto\">swinging flashlight test<\/span><\/b><span data-contrast=\"auto\">.<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"\" data-listid=\"4\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"auto\">Finally, you\u2019ll be asked to look at something far away then shift to the near target, which is then moved closer to your nose.<\/span><\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-13489 aligncenter\" src=\"https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-34.jpg\" alt=\"A girl wearing glasses presenting strabismus\" width=\"900\" height=\"700\" srcset=\"https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-34.jpg 900w, https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-34-300x233.jpg 300w, https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-34-768x597.jpg 768w, https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-34-669x520.jpg 669w, https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-34-321x250.jpg 321w\" sizes=\"auto, (max-width: 900px) 100vw, 900px\" \/><\/p>\n<h2><span class=\"TextRun SCXW205516094 BCX0\" lang=\"EN\" xml:lang=\"EN\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW205516094 BCX0\" data-ccp-parastyle=\"heading 2\">What Do the Results Mean?<\/span><\/span><\/h2>\n<p><span data-contrast=\"auto\">Typical results for the PERRLA eye exam are:<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"\" data-listid=\"6\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">The pupils are round and equal in size in bright and dim light, and they become smaller in bright light. It is also a typical result if the pupils are unequal, but only when the difference is the same in bright and dim light.<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"6\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"auto\">The direct and consensual response causes the pupils to constrict equally.<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"\" data-listid=\"6\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"auto\">The pupils constrict the same amount during the swinging flashlight test.<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"\" data-listid=\"6\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"auto\">The pupils constrict when focusing on the near target.<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"auto\">Abnormal results for the PERRLA eye exam are:<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"5\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">The pupils are irregular, oval, or not in the iris&#8217;s center.<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"5\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"auto\">The pupils are unequal, and the difference is more in bright or dim light.<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"5\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"auto\">The pupils do not respond to light.<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"5\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"auto\">The direct and consensual response causes the pupils to constrict a different amount.<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"5\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"5\" data-aria-level=\"1\"><span data-contrast=\"auto\">The pupils constrict a different amount during the swinging light test. This is revealed when one pupil becomes larger when the light is brought over from the other eye. This is called an afferent pupillary defect or Marcus Gunn pupil.<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"5\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"6\" data-aria-level=\"1\"><span data-contrast=\"auto\">The pupils do not constrict when focusing on the near target.<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2><span class=\"TextRun SCXW6716110 BCX0\" lang=\"EN\" xml:lang=\"EN\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW6716110 BCX0\" data-ccp-parastyle=\"heading 2\">Interpretation of the Results<\/span><\/span><\/h2>\n<p><span data-contrast=\"auto\">An abnormal PERRLA test can point to specific eye or systemic health problems. To help figure out what disease is the cause, doctors check for the presence of:<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">Vision loss<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"auto\">Eyes that are not pointed in the same direction (strabismus)<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"auto\">A drooping eyelid (ptosis)<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"auto\">Certain diseases of the retina or optic nerve<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"5\" data-aria-level=\"1\"><span data-contrast=\"auto\">One side of the face that doesn\u2019t produce sweat and is numb or paralyzed<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"6\" data-aria-level=\"1\"><span data-contrast=\"auto\">A dry cough<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"7\" data-aria-level=\"1\"><span data-contrast=\"auto\">Dementia<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"8\" data-aria-level=\"1\"><span data-contrast=\"auto\">Brain disorders such as aneurysms, tumors, or strokes<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2><span class=\"TextRun SCXW77556737 BCX0\" lang=\"EN\" xml:lang=\"EN\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW77556737 BCX0\" data-ccp-parastyle=\"heading 2\">Conditions Detected by the PERRLA Eye Exam<\/span><\/span><\/h2>\n<p><span class=\"TextRun SCXW252021932 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW252021932 BCX0\">A combination of exam findings will help your doctor make a specific diagnosis. While <\/span><span class=\"NormalTextRun SCXW252021932 BCX0\">additional<\/span><span class=\"NormalTextRun SCXW252021932 BCX0\"> testing is often needed to confirm, PERRLA exam findings may point to one of the following conditions:<\/span><\/span><\/p>\n<p>&nbsp;<\/p>\n<h3><span class=\"TextRun SCXW95068753 BCX0\" lang=\"EN\" xml:lang=\"EN\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW95068753 BCX0\" data-ccp-parastyle=\"heading 3\">Anisocoria<\/span><\/span><\/h3>\n<p><span data-contrast=\"auto\">Anisocoria means that the pupils are unequal in size. About two in 10 people have anisocoria. For most of them, it\u2019s \u201cphysiologic,\u201d which means that a disease does not cause it, and they\u2019ve probably had it their whole life.<\/span><\/p>\n<p><span data-contrast=\"auto\">A physiologic anisocoria diagnosis requires that the pupils&#8217; size difference is the same in dim and bright light. This requires a careful measurement by your doctor.<\/span><\/p>\n<h3><span class=\"TextRun SCXW203595188 BCX0\" lang=\"EN\" xml:lang=\"EN\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW203595188 BCX0\" data-ccp-parastyle=\"heading 3\">Afferent Pupillary Defect<\/span><\/span><\/h3>\n<p><span class=\"TextRun SCXW116081346 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun CommentStart CommentHighlightPipeRestRefresh CommentHighlightRest SCXW116081346 BCX0\">Also called Marcus Gunn pupil, this occurs when the pupils constrict differently during th<\/span><span class=\"NormalTextRun CommentHighlightRest SCXW116081346 BCX0\">e swinging light test. It <\/span><span class=\"NormalTextRun CommentHighlightRest SCXW116081346 BCX0\">indicates<\/span><span class=\"NormalTextRun CommentHighlightRest SCXW116081346 BCX0\"> that one of the eyes has trouble responding to the light. This is usually due to a problem with the retina or optic nerve and requires <\/span><span class=\"NormalTextRun CommentHighlightRest SCXW116081346 BCX0\">additional<\/span><span class=\"NormalTextRun CommentHighlightRest SCXW116081346 BCX0\"> eye tests.<\/span><\/span><\/p>\n<h3><span class=\"TextRun SCXW207733439 BCX0\" lang=\"EN\" xml:lang=\"EN\" data-contrast=\"none\"><span class=\"NormalTextRun CommentStart CommentHighlightPipeRestRefresh CommentHighlightRest SCXW207733439 BCX0\" data-ccp-parastyle=\"heading 3\">Horner Syndrome<\/span><\/span><\/h3>\n<p><span data-contrast=\"auto\">People with this condition have:\u00a0<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"11\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">A small pupil that will not get larger in the dark<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"11\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"auto\">A droopy eyelid<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"11\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"auto\">Decreased sweating on one side of the face<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"auto\">In children, it can cause the eye on the affected side to appear lighter in color. This difference in eye color is called heterochromia.<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Horner, also called Horner\u2019s Syndrome, is caused by damage to nerves that travel from the brain through the spine, lungs, and several blood vessels in the chest, neck, and head.\u00a0<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Causes include:<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"9\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">Stroke<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"9\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"auto\">Tumors, growth, or infection in the spine, lungs, or base of the skull<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"9\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"auto\">Autoimmune diseases such as multiple sclerosis<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"9\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"auto\">Neck injury<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"9\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"5\" data-aria-level=\"1\"><span data-contrast=\"auto\">Damage to blood vessels from the heart to the face and eye<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"9\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"6\" data-aria-level=\"1\"><span data-contrast=\"auto\">Surgery in the chest cavity<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"9\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"7\" data-aria-level=\"1\"><span data-contrast=\"auto\">Migraines and cluster headaches<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"auto\">To figure out whether the pupil abnormality is caused by Horner syndrome and determine the location of the damage, the doctor may use drops that contain cocaine, apraclonidine, hydroxyamphetamine, or phenylephrine.<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-13490 aligncenter\" src=\"https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-35.jpg\" alt=\"A split showing showing a blue eye with a small pupil on the top and one with a large pupil on the bottom\" width=\"900\" height=\"700\" srcset=\"https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-35.jpg 900w, https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-35-300x233.jpg 300w, https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-35-768x597.jpg 768w, https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-35-669x520.jpg 669w, https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-35-321x250.jpg 321w\" sizes=\"auto, (max-width: 900px) 100vw, 900px\" \/><\/p>\n<h3><span class=\"TextRun SCXW179755072 BCX0\" lang=\"EN\" xml:lang=\"EN\" data-contrast=\"none\"><span class=\"NormalTextRun CommentStart CommentHighlightPipeRestRefresh CommentHighlightRest SCXW179755072 BCX0\" data-ccp-parastyle=\"heading 3\">Adie Pupil<\/span><\/span><\/h3>\n<p><span data-contrast=\"auto\">A large pupil that doesn\u2019t become small in bright light could be a sign of Adie pupil (also called Adie\u2019s pupil). Other signs and symptoms include:<\/span><\/p>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">Sensitivity to light<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"auto\">Blurred vision, especially when trying to focus up close<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"auto\">Absent Achilles tendon reflex<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"auto\">Excessive sweating in some people<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"auto\">Two different concentrations of pilocarpine eye drops are used to decide whether it\u2019s an Adie pupil or something else.<\/span><\/p>\n<h3><span class=\"TextRun SCXW4347228 BCX0\" lang=\"EN\" xml:lang=\"EN\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW4347228 BCX0\" data-ccp-parastyle=\"heading 3\">Cranial Nerve III Disease<\/span><\/span><\/h3>\n<p><span data-contrast=\"auto\">Twelve cranial nerves come from the bottom of the brain (instead of the spinal cord) and provide functions that include the sense of smell, taste, sound, and balance, as well as sensation of the face and head. Some of these nerves move the larynx, tongue, face, and eye muscles.\u00a0<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">The third cranial nerve constricts the pupil, keeps the eyelid from closing, and moves the eye toward the nose, up, and downward.<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Damage to the third cranial nerve results in double vision and a droopy eyelid. Sometimes, a tumor or aneurysm in the brain presses on the nerve and affects the pupil. Therefore, a dilated pupil in combination with double vision is a medical emergency.<\/span><\/p>\n<h3><span class=\"TextRun SCXW140400881 BCX0\" lang=\"EN\" xml:lang=\"EN\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW140400881 BCX0\" data-ccp-parastyle=\"heading 3\">Argyll Robertson Pupil<\/span><\/span><\/h3>\n<p><span data-contrast=\"auto\">This disorder results in small, irregular pupils that do not respond to light but do get smaller when focusing on something close. It is caused when untreated syphilis or other conditions affect a specific part of the brain.\u00a0<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Though it is similar to Argyll Robertson pupil, the Adie pupil does not constrict when looking at a nearby object.<\/span><\/p>\n<h3><span class=\"TextRun SCXW36247460 BCX0\" lang=\"EN\" xml:lang=\"EN\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW36247460 BCX0\" data-ccp-parastyle=\"heading 3\">Iris Injury<\/span><\/span><\/h3>\n<p><span class=\"TextRun SCXW29048298 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun CommentStart CommentHighlightPipeRestRefresh CommentHighlightRest SCXW29048298 BCX0\">Surgery or trauma can damage the iris muscles and the nerves leading to them. If <\/span><span class=\"NormalTextRun CommentHighlightRest SCXW29048298 BCX0\">you\u2019ve<\/span><span class=\"NormalTextRun CommentHighlightRest SCXW29048298 BCX0\"> had eye surgery or an injury to your eye, be sure to tell your doctor. For example, blunt trauma to the eye can cause a dilated and irregular pupil that will usually go back to normal within a few months.<\/span><\/span><\/p>\n<h3><span class=\"TextRun SCXW186305146 BCX0\" lang=\"EN\" xml:lang=\"EN\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW186305146 BCX0\" data-ccp-parastyle=\"heading 3\">Pharmacologic<\/span><\/span><\/h3>\n<p><span data-contrast=\"auto\">Chemicals and drugs that get into the eye commonly cause unequal and unresponsive pupils. Agents causing a large pupil (mydriasis) are more common than those causing a small one (miosis).<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Large pupils can be caused by:<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"8\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">Nasal vasoconstrictors<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"8\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"auto\">Scopolamine patches<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"8\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"auto\">Glycopyrrolate deodorants<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"8\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"auto\">Herbals such as Jimson weed<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"auto\">Small pupils may be caused by:<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"10\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">Opiate painkillers<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"10\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"auto\">Clonidine blood pressure medication<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"10\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"auto\">Organophosphate pesticides<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"10\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"auto\">Pilocarpine glaucoma drops<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"10\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"5\" data-aria-level=\"1\"><span data-contrast=\"auto\">Prostaglandin glaucoma drops<\/span><\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-13491 aligncenter\" src=\"https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-36.jpg\" alt=\"Someone having their eyes checked by an eyecare professional\" width=\"900\" height=\"700\" srcset=\"https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-36.jpg 900w, https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-36-300x233.jpg 300w, https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-36-768x597.jpg 768w, https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-36-669x520.jpg 669w, https:\/\/img.ebdcdn.com\/blog\/wp-content\/uploads\/2025\/03\/In-content-36-321x250.jpg 321w\" sizes=\"auto, (max-width: 900px) 100vw, 900px\" \/><\/p>\n<h2><span class=\"TextRun SCXW124331199 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW124331199 BCX0\" data-ccp-parastyle=\"heading 2\">When to See a <\/span><span class=\"NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW124331199 BCX0\" data-ccp-parastyle=\"heading 2\">Doctor<\/span><\/span><\/h2>\n<p><span data-contrast=\"auto\">If you suddenly notice your pupils are unequal, see a doctor or go to the emergency room. If the following signs and symptoms are also present, have someone take you to the emergency room immediately or call an ambulance:<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/p>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"7\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">Loss of vision<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215,&quot;335559738&quot;:240}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"7\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"auto\">Double vision<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"7\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"auto\">Dizziness<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"7\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"auto\">Slurred speech<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"7\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"5\" data-aria-level=\"1\"><span data-contrast=\"auto\">Problems walking<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"7\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"6\" data-aria-level=\"1\"><span data-contrast=\"auto\">Problems with muscle strength or coordination<\/span><span data-ccp-props=\"{&quot;335557856&quot;:16777215}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"\u25cf\" data-font=\"Calibri\" data-listid=\"7\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u25cf&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"7\" data-aria-level=\"1\"><span data-contrast=\"auto\">Severe headache or neck pain<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2><span class=\"TextRun SCXW176122452 BCX0\" lang=\"EN\" xml:lang=\"EN\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW176122452 BCX0\" data-ccp-parastyle=\"heading 2\">What Is PERRLA in an Eye Exam?<\/span><\/span><\/h2>\n<p><span class=\"TextRun SCXW123498031 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW123498031 BCX0\">The PERRLA test is an integral part of the eye exam. If it picks up a problem, be reassured that most of the time, <\/span><span class=\"NormalTextRun SCXW123498031 BCX0\">it\u2019s<\/span><span class=\"NormalTextRun SCXW123498031 BCX0\"> either <\/span><span class=\"NormalTextRun SCXW123498031 BCX0\">physiologic<\/span><span class=\"NormalTextRun SCXW123498031 BCX0\"> or caused by a chemical or drug that inadvertently got into the eye. However, it occasionally signifies a much more severe health condition. Ensure you <\/span><\/span><a class=\"Hyperlink SCXW123498031 BCX0\" href=\"https:\/\/www.eyebuydirect.com\/eyecare\/find-eye-doctor\" target=\"_blank\" rel=\"noreferrer noopener\"><span class=\"TextRun Underlined SCXW123498031 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW123498031 BCX0\">get regular eye exams<\/span><\/span><\/a><span class=\"TextRun SCXW123498031 BCX0\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW123498031 BCX0\">, including the PERRLA exam, to rule out any abnormality.<\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Thomas Stokkermans OD, PhD What Is a PERRLA Eye Exam? A PERRLA eye exam evaluates the size, shape, and responsiveness of the eye&#8217;s pupils. It is part of a comprehensive eye exam and is generally done at the beginning. The results can help diagnose eye and nervous system disorders. What Does PERRLA Stand For? [&hellip;]<\/p>\n","protected":false},"author":43,"featured_media":13486,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_links_to":"","_links_to_target":"","footnotes":""},"categories":[899],"tags":[],"class_list":["post-13478","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-eyecare"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v21.2 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>What Is a PERRLA Eye Exam? | Blog | Eyebuydirect<\/title>\n<meta name=\"description\" content=\"Your eye doctor may perform a PERRLA eye exam to assess the size, shape, and responsiveness of your pupils. Abnormal results may be sign of a serious issue.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.eyebuydirect.com\/blog\/what-is-perrla-eye-exam\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"What Is a PERRLA Eye Exam? | Blog | Eyebuydirect\" \/>\n<meta property=\"og:description\" content=\"Your eye doctor may perform a PERRLA eye exam to assess the size, shape, and responsiveness of your pupils. 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