Which pupillary or pupil-related sign is listed as a sign of fundic disease?

• A. Dilated, poorly or non-responsive pupils
• B. Normal pupil response
• C. Increased tear production
• D. Dazzle reflex excessive

Answer: (A)

Pupillary responses rely on the retina and optic nerve to send the signal to constrict in response to light. When fundic disease affects the retina or optic nerve, the afferent input to the pupil control pathway is impaired, so the pupil constricts poorly or not at all and can appear dilated. This makes a dilated, poorly or non-responsive pupil a classic sign of fundic pathology, since it reflects dysfunction in the structures at the back of the eye that constitute the fundus. A normal pupil response would suggest the fundus and its afferent pathways are functioning, making fundic disease less likely. Increased tear production isn’t tied to fundus health, and an excessive dazzle reflex isn’t a typical or specific sign of fundic disease.