When you go to see a doctor, or at the hospital, you've probably seen a doctor or nurse take a small flashlight and shine it into your eyes, right? Some people think that this is just to see if your eyes can see. But in fact, this simple test can reveal a lot of important information about the health of our eyes, as well as the health of our entire body, especially the brain. Let's talk about this test today.
What exactly is PERRLA?
Simply put, PERRLA is an acronym used by doctors and healthcare professionals. It's like abbreviating our names. It's a way for them to easily check whether your pupils are working properly. The little black spot in the middle of the black ring of your eye is what we call the pupil. Each letter in the word PERRLA stands for something. Let's see what they mean.
| Letter | Meaning & Explanation |
|---|---|
| Pupils | This is about your pupils. These should be exactly in the middle of the colored part of your eye (iris). |
| And which one? | A healthy person's two eyes should have the same size (equal) pupils. If one is larger and the other is smaller, it can be a problem. |
| Round | Healthy corneas should be perfectly round . If they are out of shape, that is also a matter of concern. |
| Reactive to | This means responding. What are you responding to? The next letter says it. |
| Light | Response to light. When the doctor shines a flashlight, a healthy cornea should constrict to control the amount of light entering. In the dark, it should dilate to let in more light. |
| Accommodation | This is a bit complicated. Simply put, when you look at something close and something far away, the size of your pupils should change. When you look at something close (e.g. a finger), the pupils get smaller, and when you look at something far away (e.g. a clock on the wall), the pupils get bigger. This tests your eyes' ability to focus. |
How is this PERRLA test done?
This is a very simple, painless test. You may have experienced this too.
Usually, the doctor will take you to a slightly darkened room and have you sit in a chair. Then, they will do a few things like:
- First, they will simply look at your eyes and check if the size and shape of the corneas are the same.
- Then, you will be asked to look straight ahead, and a small flashlight (penlight) will be used to shine the light into one eye for a few seconds, then into the other eye. This is also called a ``light reflex test.'' This is done to see if the pupil dilates to light.
- At another time, the torch is rapidly switched from one eye to the other. This is called the ``Swinging light test.'' This can also provide important information about nerve function.
- Finally, you will be asked to look at one of their fingers or a pen. Then they will move it closer to your face, further away, and to the sides. This will test whether your eyes are functioning properly at near and far distances (accommodation).
This entire test takes about a minute, but the information it provides is priceless.
Why are the results of this test so important?
If the results are 'normal', it means that your corneas are functioning well. But if the results are 'abnormal', it can give clues about a variety of things. It could be something as simple as needing glasses, or it could be a warning sign of a more serious underlying condition.
Problems that can be related to the eyes themselves
- Anisocoria: This is a condition where the size of the two pupils of the eyes is different. For some people, this may be a normal condition that is present from birth. However, if it happens suddenly, it should be checked out.
- Eye trauma: When something hits the eye, it can damage the muscles or nerves inside.
- Glaucoma: A disease in which the optic nerve is damaged due to increased eye pressure.
- Optic neuritis: Inflammation of the nerve that connects the eye to the brain.
Problems that may involve the brain and nervous system
There is a very strong connection between our eyes and our brain, so changes in the way our eyes function can sometimes be a sign of a problem in the brain.
- Stroke: Impaired blood flow to the brain.
- Brain tumor: An abnormal growth of cells in the brain.
- Aneurysm: A weakened blood vessel in the brain that bulges like a balloon.
- Concussion: An injury to the brain caused by a blow to the head.
- Seizure: A sudden change in the electrical activity of the brain.
In such cases, an abnormal result from the PERRLA test can be the first clue that further testing is needed to diagnose the disease . This is why doctors first look at the eyes with a flashlight, even after an accident.
When to take care of your eyes
This test is usually performed by a doctor, but if you notice anything unusual about your eyes, you should be concerned.
- If you look in the mirror and see that your two eyes are not the same.
- If your vision suddenly becomes blurry, or if you see two or more things.
- If you have an unbearable headache accompanied by a change in your vision.
- If you have a change in vision along with vomiting and dizziness after hitting your head somewhere.
In any such situation , see a doctor immediately. In the event of an emergency, such as an accident, do not delay in going to the Emergency Treatment Unit (ETU) of the nearest hospital.
Take-Home Message
- PERRLA is a simple, painless method that doctors use to check the health of the pupils in your eyes.
- This simple test can provide important clues not only about the health of the eyes, but also about serious conditions related to the brain and nervous system.
- If you experience a sudden change in your vision, a change in the size of your corneas, or a head injury , see a doctor without delay.
- Since the risk of developing eye diseases increases with age, it is very important to have regular eye exams, even if there are no symptoms.
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