PERRLA stands for which description of the pupillary response?

• A. Pupils equal, round, reactive to light, and accommodating
• B. Pupils equal, round, reactive to light, but not accommodating
• C. Pupils unequal, round, reactive to light, and accommodating
• D. Pupils equal, oval, reactive to light, and accommodating

Answer: (A)

PERRLA describes a normal pupillary assessment, focusing on four aspects of the pupil’s response. Pupils are equal in size, meaning there’s no anisocoria. They are round in shape. They are reactive to light, showing the direct light reflex and the consensual reflex in the opposite pupil. They are accommodating, meaning they constrict when focusing on a near object and the eyes converge appropriately. When all four are present, the description is Pupils equal, round, reactive to light, and accommodating. If any part is off—unequal size, an oval shape, not reacting to light, or not accommodating—that signals an abnormal finding.