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Swinging light test

The swinging-light-test is used to check for relative afferent pupillary defect RAPD. Often, however this pupil defect is subtle. The swinging light test enables you to pick this up by comparing the pupil response between the eyes. Swing the light back-and-forth between the eyes. Normally, the pupil will constrict with one eye, dilate a little as the light passes over the nose, and constrict again with the other eye. Thus, you get constrict — constrict — constrict — constrict.
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How to test for a relative afferent pupillary defect (RAPD)

Swinging light test
Swinging light test
Swinging light test
Swinging light test
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The Swinging Flashlight Goes Digital

The swinging-light-test is used to check for relative afferent pupillary defect RAPD. Often, however this pupil defect is subtle. The swinging light test enables you to pick this up by comparing the pupil response between the eyes. Swing the light back-and-forth between the eyes. Normally, the pupil will constrict with one eye, dilate a little as the light passes over the nose, and constrict again with the other eye. Thus, you get constrict — constrict — constrict — constrict.
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Relative Afferent Pupillary Defect

The pupil has tight neurological control and abnormalities of this control correlate with underlying diagnoses. The exam and those diagnoses are covered here. There are a handful of pupillary abnormalities that every clinician should know.
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The test can be very useful for detecting unilateral or asymmetrical disease of the retina or optic nerve but only optic nerve disease that occurs in front of the optic chiasm. The physiological basis of the RAPD test is that, in healthy eyes, the reaction of the pupils in the right and left eyes are linked. In other words, a bright light shone into one eye leads to an equal constriction of both pupils.
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