Pupil Disorders Flashcards
Which nervous system constricts the pupils
Parasympathetics using Ach
Which nervous system dilates the pupils
Sympathetic using adrenaline
How can uveitis cause abnormal pupil shape
Can cause ahesions in the iris
How can AACG cause abnormal pupil shape
Ischaemic damage to the muscles of the iris, usually vertical oval shape
What is a coloboma
Congenital malformation in the eye which can cause a hole in the iris causing irregular shape
What is a tadpole pupil
Spasm in the segment of the iris, usually temporary associated with migraines
Causes of mydriasis (dilated pupil)
Third nerve palsy, Holmes-Adie syndrome, raised ICP, congenital, trauma, stimulants such as cocaine, anticholinergics
Causes of miosis (constricted pupil)
Horner’s syndrome, cluster headaches, Argyll-Robertson pupil, opiates, nicotine, pilocarpine
What does third nerve palsy cause
Ptosis, dilated non-reactive pupil, divergent strabismus in affected eye
Causes of third nerve palsy with pupil sparing
Microvascular cause as parasympathetic fibres are spared. Diabetes, HTN, ischaemia
Causes of full third nerve palsy
Compression of nerve including parasympatheric fibres. Idiopathic, tumour, trauma, cavernous sinus thrombosis, posterior communicating artery aneurysm, raised ICP
Triad in Horner’s syndrome
Ptosis, miosis, anhidrosis
Central lesion causes of Horner’s
Stroke, MS, tumours, syringomyelia
Pre-ganglionic causes of Horner’s
Tumour, trauma, thyroidectomy, top rib
Post-ganglionic causes of Horner’s
Carotid aneurysm, carotid artery dissection, cavernous sinus thrombosis, cluster headache
