Relative afferent pupillary defects in multiple sclerosis.

Relative afferent pupillary defects were found in 69 of 386 patients (18%) seen by the author at the University of British Columbia Multiple Sclerosis Clinic between Feb. 1, 1985, and Apr. 30, 1987. Pupil defects were more common in patients with clinically definite multiple sclerosis, those with recent or unilateral optic neuritis and those with unilateral or asymmetric optic atrophy. A relative afferent pupillary defect was found in 15 patients with no history of optic neuritis, 5 patients with no optic atrophy and 2 patients with normal visual evoked potentials. The frequency of relative afferent pupillary defects after optic neuritis in this group of patients was much lower than that found in a previous study of patients who presented with optic neuritis.