Author: nuke, Posted on Wednesday, November 05 @ 11:45:03 IST by RxPG  

  Add to My Pages    Printer Friendly    Email Story   Download Story  Ophthalmology alerts 

Bilateral

Miosis – pupillary constriction Iridocyclitis, miotic eye drops (pilocarpine)

Mydriasis – pupillary dilation Iridocyclitis, mydriatic or cycloplegic drops (atropine); midbrain (reflex arc) lesions or hypoxia; oculomotor CNIII damage; acute angle glaucoma

Failure to respond (constrict) with ­ light stimulus Iridocyclitis; corneal or lens opacity; retinal degeneration; optic nerve CNII destruction; midbrain synapses involving afferent pupillary fibers or oculomotor nerve; impairment of efferent fibers that innervate sphincter pupillae muscle

Argyll Robertson pupil Bilateral, miotic, irregularly shaped pupils that fail to constrict with light but retain constriction with convergence; pupils may or may not be equal in size; commonly caused by neurosyphilis or lesions in midbrain


Unilateral

Anisocoria – unequal pupils Congenital or caused by local eye medications, amblyopia or unilateral sympathetic or parasympathetic papillary pathway destruction

Iris constrictive response Acute uveitis is frequently unilateral; constriction of pupil accompanied by pain and cicumcorneal flush

Oculomotor nerve damage Pupil dilated and fixed; eye deviated laterally and downward; ptosis

Adie pupil (tonic pupil) Affected pupil dilated and reacts slowly or fails to react to light; responds to convergence; caused by impairment of postganglionic parasympathetic innervation to sphincter pupillae muscle or ciliary malfunction; often accompanied by diminished tendon reflexes (diabetes or alcoholism)