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Why do we shine lights in the eyes of conscious patients after head injury?

BMJ 2016; 354 doi: https://doi.org/10.1136/bmj.i5235 (Published 30 September 2016) Cite this as: BMJ 2016;354:i5235

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Re: Why do we shine lights in the eyes of conscious patients after head injury?

I agree with your premise but don't agree with your conclusion.

Every patient is different and some tolerate especially younger patient injury well and can mask the symptoms very well making to difficult to get a clear picture from GCS but pupillary abnormality is difficult to fake.

Similarly patients with regular excessive alcohol usage and who are drunk when have head injury are also difficult. It would be difficult to accurately measure GCS in them depending on level of alcohol on board but pupillary irregularity will certainly help big time.

As far getting brain scans are concerned I think better training for the physicians will make more of difference in recognising physiological anisocoria and previously damaged eye.

Competing interests: No competing interests

30 October 2016
Muhammad Butt
Doctor
Nobles hospital