Certified Ophthalmic Medical Technologist (COMT) Practice Exam

What type of pupil reaction indicates light-near dissociation?

1. Pupils that constrict equally to all stimuli

2. Pupils that are only reactive to light

3. Pupils that are only reactive to accommodation

4. Pupils that dilate uniformly in all conditions

The correct answer is: Pupils that are only reactive to accommodation

Light-near dissociation is a phenomenon observed when there is a differential reaction of the pupils to light and accommodation. In this condition, the pupils show a normal response to accommodation (the process of adjusting the focus for near vision) but have reduced or no response to light. Thus, pupils that are reactive only to accommodation demonstrate this characteristic. This specific pupil response is often seen in certain neurological conditions and indicates that the pathways for light response are affected while the accommodation pathways remain intact. Understanding light-near dissociation is crucial in ophthalmology as it helps clinicians assess and diagnose underlying neural issues.