Anisocoria
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Revision as of 17:18, 30 August 2023 by Aidan (talk | contribs) (Created page with "== Background == * Pupils of different sizes * Usual pathophysiology includes imbalance of efferent autonomic nerves ** Parasympathetic causes miosis/constriction and sympathetic causes mydriasis/dilatation * Other cause is mechanical == Etiologies == * Greater difference in dim light ** Horner syndrome, with ipsilateral miosis, ptosis, anhidrosis, enopthalmos, and lack of ciliospinal reflex ** Cholinergic medications, such as pilocarpine to treat glaucoma...")
Background
- Pupils of different sizes
- Usual pathophysiology includes imbalance of efferent autonomic nerves
- Parasympathetic causes miosis/constriction and sympathetic causes mydriasis/dilatation
- Other cause is mechanical
Etiologies
- Greater difference in dim light
- Horner syndrome, with ipsilateral miosis, ptosis, anhidrosis, enopthalmos, and lack of ciliospinal reflex
- Cholinergic medications, such as pilocarpine to treat glaucoma
- Posterior synechiae
- Greater difference in bright light
- Cranial nerve III palsy, typically from compression of the third nerve inhibiting parasympathic fibres, and typically with ptosis, possibly "down and out" eye
- May be caused by uncal brain herniation, usually with decreased level of consciousness
- Migraine
- Cycloplegic medications, such as atropine, cyclopentolate, and tropicamide
- Sympathomimetics
- Tonic pupil (Adie pupil), more common in young women and is benign
- Traumatic mydriasis
- Cranial nerve III palsy, typically from compression of the third nerve inhibiting parasympathic fibres, and typically with ptosis, possibly "down and out" eye
- Equal difference in bright and dim light
- Physiologic anisocoria
