Aniscoria

Last updated 20.09.12

 

Index

 

Definition

-  Unequal pupil diameters

 

Features

-  Parasympathetic constrict pupil

-  Sympathetic dilates pupil

-  May be an incidental finding

-  Old photographs may help date onset

 

Causes

-  Horners Syndrome: ipsilateral miosis

-  Physiological or transient (Migraine)

-  AdieŇs Sectorpalsy

-  Pharmacological

-  Atropine, pilocarpine

-  Toxic plants

-  Mechanical

-  Iris damage or inflammation (uveitis)

-  Globe rupture

-  Eye Sx: cataract extraction

-  Colomboma

-  Intracranial bleed (via block of CNII parasymp)

-  Head injury: subdural

-  SAH

 

Associated S/S

-  No direct symptoms from pupil changes

-  Tear drop pupil: globe rupture, foreign body, colomboma

-  Pain: intracranial bleed, carotid dissection

-  Diplopia, ptosis: CNIII (Occulomotor nerve) palsy

-  Proptosis: intracranial lesion (space occupying)

 

Ix

- Eye Exam

-  Slit lamp: iris damage

- As per cause

-  +/- MRI: CNIII, Horners Syndrome