Certified Ophthalmic Medical Technologist (COMT) Practice Exam

What is light-near dissociation?

1. Pupils that are constricted in light but dilate in dark

2. Pupils that are responsive to accommodation but not to light

3. Pupils that react equally to light and dark

4. Pupils that are excessively dilated in bright light

The correct answer is: Pupils that are responsive to accommodation but not to light

Light-near dissociation refers to a specific phenomenon where the pupils demonstrate a distinct response pattern to differing stimuli. In this case, the pupils are responsive to the act of accommodation—an adjustment of the lens for near vision—but do not react to light in a typical manner, failing to constrict in response to bright light stimulus. Understanding this concept is essential in clinical settings, as it can indicate certain neurological conditions. For instance, in conditions such as Argyll Robertson pupils, individuals exhibit this dissociation. They have pupils that constrict when focusing on a near object but remain dilated in response to light. This contrasts with normal pupil responses, which show constriction in both light and accommodation stimuli. Recognizing this pattern is crucial for healthcare professionals when assessing and diagnosing potential ocular or neurological disorders.