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February 1979

Relative Afferent Pupillary Defects in Glaucoma Without Characteristic Field Loss

Author Affiliations

From the Department of Ophthalmology, Mount Sinai School of Medicine of The City University of New York. Dr Kohn is a fellow of the Heed Foundation, Chicago, and Dr Moss is a fellow of Fight for Sight, Inc, New York.

Arch Ophthalmol. 1979;97(2):294-296. doi:10.1001/archopht.1979.01020010146010

• Four patients had relative afferent pupillary defects, asymmetric glaucomatous cupping of the optic nerve head, asymmetric intraocular pressure, and normal kinetic visual fields. The "Gunn pupil" can be a sign of early asymmetric glaucoma at a stage before visual field defects can be demonstrated by standard perimetry. Three other patients with afferent pupillary defects and asymmetric intraocular pressures and cupping showed early visual field defects only on repeated, refined perimetry. No visual field defects were found in five patients with asymmetric cupping and clinically normal pupillary findings.

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