Marcus Gunn pupils are a rare problem that occurs in the eye. This condition causes sufferers to not be able to respond to the light from inside the eye equally, but their eyes respond to light differently.
Different responses from the two eyes indicate that the eye has a problem, this could be a result of problems with the optic nerve or diseases of the retina.
When the eyes are exposed to light, normal pupils will shrink and turn smaller. Marcus Gunn pupils under certain conditions can continue to grow in different sizes.
Patient Marcus Gunn pupil does not pose a risk to himself but this is an indication of other problems that occur in his eyes and must be treated and cured.
Symptoms and Types of Marcus Gunn Pupils
Marcus Gunn pupillary disease is a health problem named by a health expert named Robert Marcus Gunn, this is an ophthalmologist from Scotland in the 1800s.
Sufferers of Marcus Gunn pupil will groan because his eyes cannot see perfectly. If you ask your doctor for advice, the doctor must ensure the difference in vision.
Is the problem caused by Marcus Gunn’s pupil or is it caused by other problems that may occur such as cataracts or non-RAPD.
The types of RAPD, and non-RAPD that cause Marcus Gunn pupil symptoms are:
- No RAPD: There are other conditions that cause it, such as hippus (fluctuation in pupil size) and non-reactive pupils, that can make spotting RAPD difficult.
- Mild RAPD: A weak constriction occurs in the pupil, before then it can spread to a larger area.
- Moderate RAPD: Infected pupils cause stable and unchanging pupil constriction, they can also spread to other areas.
- Severe RAPD: In this condition, infected pupils can apparently cause disease suddenly.
Some of the causes of Marcus Gunn pupils
– Unilateral optic neuropathy, this condition usually causes vision loss
– Optic neuritis
– Serious glaucoma that can damage the optic nerve
– Traumatic optic neuropathy, including direct ocular trauma, orbital trauma, and head injuries that cause damage to the optic nerve
– Optic nerve tumors, but this is very rare
– Orbital diseases, including damage to the optic nerve from orbital tumors, thyroid-related orbitopathy, or vascular malformations
– Nerve degeneration is called optic atrophy
– Optic nerve infection or inflammation of the optic nerve
– Ischemic retinal diseases such as central retinal artery occlusion, ischemic central retinal vein occlusion, or sickle-cell retinopathy
– Retinal detachment
– Severe macular degeneration
– Retinal infection
– Chronic lazy eye, also called amblyopia
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Marcus Gunn Pupil Diagnosis
Now, we see how the diagnosis of marcus gunn pupils is made. Both eyes will narrow simultaneously when illuminated by light, this is a normal eye condition because the two eyeballs are interrelated.
This situation is called consensual light reflex, this diagnostic test is usually referred to as the Marcus Gunn test, some also call it as “swinging flashlight test.”
When the eyes are illuminated, the eyes will react to the light because light enters to the eye, this is called the path of light reflexes and it is divided into two:
- The afferent pathway: Pupils send signals to the brain along the optic nerve.
- The efferent pathway: The message is sent back to the brain via the nerve pathway, this is why the two pupils become wrinkled.
This eye irradiation test must be done by an expert, an eye doctor and must be done in a half-dark room. Usually the doctor will illuminate or hold the light in front of one eye for three seconds and then it will be done on the other eye.
If the patient’s eye experiences marcus gunn pupils, he will not contract as normal eyes do. This indicates that the eye is experiencing Marcus Gunn Pupil problems.
This disease is difficult to recognize without testing, so a doter can only find out the condition after carrying out the test as above, by illuminating the eyes with light.
Marcus Gunn Pupils Treatment
Treatment of Marcus Gunn Pupil is not done directly on the problem because Marcus Gunn Pupil is a sign of another problem.
So, the treatment is to treat the cause of the emergence of marcus gunn pupils (as we have mentioned above)
Some conditions that can cause Marcus Gunn are as follows:
- Severe glaucoma: This condition can be treated with a laser, eye drops, and can also be treated with surgery but depends on the cause.
- Optic neuritis: This will usually improve without treatment, but if you want to treat it you can use steroids. If there is pain, this can be treated with over-the-counter pain relievers.
- Optic atrophy: This condition cannot be treated. So, what must be done is to stop its development.
- An optic nerve tumor: Treated according to the state of the tumor disease, because there are two types; benign tumors and malignant tumors or cancer.
- Retinal detachment: Not everything can be treated, if it can be treated, it must be surgically removed, but this depends on the remaining soluble tissue. If it is very thin, it may not be possible to operate. If you take the road of operation, this also does not guarantee 100%, the most successful rate is around 80-90%. Even if it is successful, the second operation sometimes needs to be done. But there is a scary thing, if the retina that has been operated can not be installed again, blindness will occur in the eye.
- Retinal infection: Retinal infection can be treated with oral medication, or by injecting the eyeball. But this condition can also be treated with a laser. This depends on the doctor how he sees and studies this problem.
- Severe unilateral macular degeneration: Now there is no solution to the drug, but can slow down its development.
- Lazy eye: If the cause of marcus gunn pupils is lazy eye, then this can be treated with certain glasses, vision therapy, eye drops and patches.
That’s a glimpse of the explanation of Marcus Gunn Pupils disease, starting from its understanding, its causes, diagnosis, and possible treatment.
Sources:
https://www.ncbi.nlm.nih.gov/books/NBK557675/
https://stanfordmedicine25.stanford.edu/blog/archive/2013/Do-you-know-Marcus-Gunn.html
