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  1. Amy L Hennessy1,
  2. Joanne Katz2,
  3. Rengappa Ramakrishnan3,
  4. Ramasamy Krishnadas,
  5. Ravilla D Thulasiraj4,
  6. James M Tielsch2,
  7. Alan L Robin5
  1. 1Baltimore, Maryland, USA
  2. 2Department of International Health, Johns Hopkins University, Maryland, USA
  3. 3Aravind Eye Hospital Tirunelveli, Tirunelveli, India
  4. 4Aravind Eye Hospital Madurai, Madurai, India
  5. 5Department of Glaucoma, Johns Hopkins University, Baltimore, Maryland
  1. Correspondence to Dr Amy L Hennessy, 1333 E Clement Street, Baltimore Maryland 21230, USA; hennessy.amy{at}gmail.com

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We appreciate both the interest in our manuscript and the comments made by our colleagues, and we would like to take this opportunity to respond. First, we did not conclude that an afferent pupillary defect (APD) was not a helpful tool for any glaucoma screening; in truth, it may inexpensively help to distinguish normal cases from abnormal ones. An APD is relatively non-specific and may be caused by a number of conditions other than …

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