Twilight (2008)

If you are looking for a Hollywood depiction of how to perform a lousy pupil exam, look no further than the teen Vampire romance Twilight. After nearly being struck by an out-of-control van, we see our heroine Bella Swan being evaluated in the emergency room. The doc working in the ER does a cursory penlight pupil exam, presumably checking for anisocoria (unequal pupil size) in the setting of possible head trauma.

I can't really criticize the depiction of this exam for two reasons. First, the doc is actually protagonist Edward Cullen's father, and he pretty much knows that his son rescued Bella from any harm. His exam is more about appearances and going through the motions. Second, in my experience, this type of quick and poorly performed eye evaluation is, unfortunately, quite typical in the emergency room setting. Note the doctor's improper instruction for Bella to fixate on his hand near her face, which would stimulate her accommodative pupil response. Further, he assesses the direct pupillary response bilaterally, but fails completely to perform the essential Marcus Gunn pupil exam. The viewer is referred here for instructions on how to properly perform and document the pupil exam.

As a movie, though, Twilight is a triumph of casting, and manages to achieve a good balance between teen romance and semi-action flick. I particularly liked the first half and the well-acted awkwardness by Bella. This one gets a B from me. Let's hope for some more ophthalmology content in the sequels!