The Concussion Eye Test with Flashlight: A Guide for Initial Assessment

Various tests are available to assess the severity of a concussion. Some require expensive medical tests, while others can be done at home for free. One easy and reliable test you can perform at home is a concussion eye test using a flashlight. It’s a reliable indicator of concussion and can be used as a preliminary tool to assess whether or not you should seek out more specialized care. This article will discuss how to do it, why it is essential, and more specific alternatives to get the same information.

Understanding Concussion and Its Impact on the Eyes

Concussions can affect a large number of areas, and the easiest way to gauge the severity of the injury is by looking at the eyes. The eyes aren’t an extension of the brain; they ARE the brain. For this reason, you can gather helpful information regarding a concussion by examining the pupils and how they respond to light.

Using light to assess pupillary responses can help identify the presence and severity of a concussion. Observing the speed, duration, and amount of pupil constriction are all factors in determining where and how severe a concussion is. This is due to the complexity of the pupillary light response, which involves a complex network of regions that include the autonomic system, cranial nerves 2 and 3, various levels of the brainstem, and the parietal and temporal lobes.

How to Perform the Concussion Eye Test with a Flashlight

This simple test can be performed anywhere and only requires a dim room and a flashlight. The light on a cell phone works but is typically a little too bright for someone with a fresh concussion. If you’re using a phone flashlight, see if you can turn the brightness down.

1. Dim the lights: The test works better in a dim room because the pupils will be more dilated, making it easier to see the pupillary response.

2. Explain the Procedure: Instruct the person to look straight ahead and that you’ll be shining a light into each of their eyes several times from different angles.

3. Observe Initial Eye State: First, look at the person’s eyes without the flashlight. Note any visible irregularities in pupil size or shape.

4. Assessing the four quadrants: Start with the bottom left, then the bottom right, move to the top left, and finally to the top right. Do not shine directly into the eye from head-on. Come in at a 45-degree angle.

5. Observe Pupillary Response: A healthy reaction includes pupils constricting briskly and equally as they respond to the light. They should stay constricted until you remove the light.

What to Look For

-Presence of Reflex: The main thing to look for is whether or not the pupil constricts. Also, look for the eye’s ability to hold the constriction for 3-5 seconds. If it dilates quickly, take note, as that is an abnormal finding.

–Equal Pupil Size and Shape: Look for differences in the pupils’ size at rest and during the test. Note whether they are different sizes or if one is less responsive than the other.

-Constriction of the Opposite Pupil: The opposite pupil should constrict while examining the eye. If it does not, it could signal a more severe injury.

Limitations of the Concussion Eye Test with Flashlight

-This test is an excellent first-line screening. Still, there are other substitutes for a full neurologic workup from a qualified professional. Use this information as an essential checkpoint to decide whether or not to pursue medical care.

-Concussions can affect other areas that don’t control the eyes, so many may assume a regular test means everything is ok. The eyes are commonly affected by a concussion, but not always.

–User Error: Even trained professionals struggle to identify abnormalities in pupillary function. If you don’t need to know what you’re looking for, it can be challenging to tell whether or not what you’re seeing is normal.

The Easiest Way to Assess Pupil Function

The point mentioned above regarding user error is arguably the most important. Thankfully, there are tools available to quickly and accurately assess pupillary function. The best one we use in our clinic is called “reflex.” You can sign up for a free 14-day trial, and it allows you to objectively measure pupillary constriction, time to fatigue, symmetry, and several other important metrics that are challenging to identify with the naked eye. More importantly, it will tell you how likely it is that you’ve sustained a concussion. If you try the flashlight test and don’t know if you see anything abnormal, try reflex.

Note: I am not affiliated with the following company or receive compensation for recommending the app. I include it in this article because I’ve found it easy to use and effectively providing accurate data.

When to Seek Medical Attention

You should seek medical care immediately if you experience any of the following symptoms.

• – New severe or worsening headaches
• – Loss of consciousness
• – Persistent vomiting
• – Seizure activity
• – Progressively worse balance issues
• -Progressively worsening double vision

Conclusion

The eyes are the only part of the brain you can see with the naked eye. They aren’t an extension of the brain; they are the brain. Using them to assess concussion symptoms is a valuable tool that serves as an easy baseline to determine if you need further evaluation. Things like pupil size and shape, response to light, and ability to sustain constriction are all reliable indicators that a concussion has taken place. Start with this test, and if you feel something is off, consult a medical professional to determine the course of action most appropriate.

If you have questions about where to turn after a concussion, click here to schedule a complimentary consultation with one of our doctors. We’ve treated hundreds of complex concussion cases and can help piece together the missing pieces in your recovery.

*Note: The information provided in this article is for educational purposes only and does not constitute a doctor-patient relationship. Patients are advised to consult their medical provider or primary care physician before trying any remedies or therapies at home.