Pupil abnormalities

Question 1

What are the sign’s of Horner’s syndrome?

Answer 1

Miosis
Ptosis
Anhydrosis

Question 2

How can a horner’s syndrome be diagnosed?

Answer 2

Topical cocaine dilates the normal pupil but not the Horner’s pupil
Topical apraclonidine dilates the dodgy pupil but not the normal pupil (responds to denervation)

Question 3

What are the key differences between horner’s syndrome and 3rd nerve palsy?

Answer 3

Horner’s: ptosis, miosis, anhydrosis

3rd nerve: ptosis, down and out, pupil may be large(surgical) or not involved (medical)

Question 4

What is holmes-adie pupil?

Answer 4

Damage to post-gangionic parasympathetic nerve fibres cause a semi-dilated pupil that reacts poorly to light and accommodation

Question 5

How do you confirm holmes-adie pupil?

Answer 5

Pilocarpine 0.1% abnormal pupil will constrict whilst normal pupil will not

Question 6

What are some causes of RAPD?

Answer 6

Disease of optic nerve
Retinal detachment
Severe wet macular degeneration
Not caused by any corneal opacity