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Swinging light test

swinging light test --> alternating light test

test to detect a relative afferent defect in one eye by watching pupillary movements.

With the patient fixing in the distance, the light is held on each eye for about a second, and quickly moved to the other eye. Assuming no defect of the innervation to the iris sphincter in one eye (which would produce an anisocoria in light), the eye with the weaker light response has a relative afferent pupillary defect.

This asymmetry of pupillomotor input can be estimated by holding neutral density filters in front of the better eye until the pupillary responses of the two eyes are balanced.

Synonym: swinging light test.

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