Advanced Health Assessment Practice Exam

What is indicated by an asymmetric corneal light reflex in a child older than 6 months?

1. Normal variation

2. Muscle imbalance

3. Possible eye infection

4. Need for glasses

The correct answer is: Muscle imbalance

An asymmetric corneal light reflex in a child older than 6 months indicates a muscle imbalance, particularly in the extraocular muscles. The corneal light reflex test checks the alignment of the eyes and how well they are coordinated. When the light is reflected equally in both pupils, it generally suggests normal ocular alignment. However, if the reflection is asymmetric, it can indicate that one eye may be misaligned, which is often due to a condition called strabismus. Strabismus can result from imbalances in the muscle control of the eyes. When one muscle is stronger or weaker than its counterpart, it can lead to eyes that do not focus on the same point, causing the corneal reflex to appear uneven. Recognizing this imbalance early is crucial because untreated strabismus can affect vision development and lead to amblyopia, or "lazy eye." Variations in corneal light reflex are typically not considered normal after 6 months of age since visual development milestones reach a critical point around that time. Conditions like infections or the need for glasses are less likely to cause an asymmetric reflex, making the indication of muscle imbalance the most direct and relevant explanation for the observed phenomenon.