What does the acronym PERRLA stand for?

What does the acronym PERRLA stand for?

• A. Pupils Equal, Round, React to Light, and Alignment
• B. Pupils Equal, Round, React to Light, and Accommodation
• C. Pupils Equal, Round, React to Light, and Angulation
• D. Pupils Equal, Round, React to Light, and Adduction

Answer: (D)

PERRLA is a quick neuro-ophthalmic check of the pupils that documents four features to evaluate the eyes’ sensory and motor pathways. Pupils Equal means both pupils are about the same size, which helps detect unequal pupil size (anisocoria) that could signal a problem. Round describes the shape being smooth and circular, indicating normal pupil contour. React to Light refers to the pupillary light reflex: when light is shone into one eye, both pupils constrict (a direct reflex in the illuminated eye and a consensual reflex in the other eye). Accommodation tests how the pupils respond when focusing on a near object—both pupils should constrict as the eyes converge to maintain focus on a close target. This near response is part of the parasympathetic pathway that also governs the light reflex. The correct ending is Accommodation, not Adduction. Adduction is a term for inward eye movement and is related to extraocular muscle function, not to the PERRLA assessment. PERRLA helps screen for neurologic issues affecting the eye and its nerves, such as cranial nerve III function or issues with the autonomic pathways controlling pupil size and lens accommodation.

PERRLA is a quick neuro-ophthalmic check of the pupils that documents four features to evaluate the eyes’ sensory and motor pathways. Pupils Equal means both pupils are about the same size, which helps detect unequal pupil size (anisocoria) that could signal a problem. Round describes the shape being smooth and circular, indicating normal pupil contour. React to Light refers to the pupillary light reflex: when light is shone into one eye, both pupils constrict (a direct reflex in the illuminated eye and a consensual reflex in the other eye). Accommodation tests how the pupils respond when focusing on a near object—both pupils should constrict as the eyes converge to maintain focus on a close target. This near response is part of the parasympathetic pathway that also governs the light reflex.

The correct ending is Accommodation, not Adduction. Adduction is a term for inward eye movement and is related to extraocular muscle function, not to the PERRLA assessment. PERRLA helps screen for neurologic issues affecting the eye and its nerves, such as cranial nerve III function or issues with the autonomic pathways controlling pupil size and lens accommodation.