Pupil Disorders Flashcards
Causes of abnormal pupil shape
AACG
Trauma to circular/radial muscles e.g. rrom surgery
Anterior uveitis
Rubeosis iridis
Coloboma
Tadpole pupil
What pupil defect is Horner syndrome and migraines associated with
Tadpole pupil
Causes of myadriasis
Congenital
Stimulants
Anticholinergics
Trauma
Third nerve palsy
Holmes-Adie syndrome
Raised intracranial pressure
Acute angle-closure glaucoma
Causes of miosis
Horner syndrome
Cluster headaches
Argyll-Robertson pupil (neurosyphilis)
Opiates
Nicotine
Pilocarpine
Features of third nerve palsy?
Ptosis
Non reactive dilated pupil
Divergent strabismus (down and out eye)
Causes of third nerve palsy
Idiopathic
Tumour
Trauma
Cavernous sinus thrombosis
Posterior communicating artery aneurysm
Raised ICP
What to consider if third nerve palsy does not caused a fixed dilated pupil?
Suggests microvascular causes of the palsy as the parasympathetic fibres are spared. e.g.
Hxn
Diabetes
Ischaemia
What condition is associated with miosis, ptosis, anhidrosis of face, arm and trunk and/or enophthalmos?
Horner syndrome
What causes Horner syndrome?
Damage to Sympathetic NS of the face due to central/pre and post ganglionic lesions e.g
Central - stroke, MS
Pre-ganglionic - Tumour, thyroidectomy, top rib
Post ganglionic - Cartoid aneurysm, Cavernous sinus thrombosis
What is congenital horner syndrome associated with
Heterochromia
Diagnosis of horner syndrome
cocaine eye drops
What pupil is associated with dilation, sluggish pupillary light reflex, responds to accommodation, a tonic pupil and absent ankle+knee reflexes?
What is this caused by?
Holmes-adie pupil
Damage to post ganglionic parasympathetic NS
What pupil is associated with no pupillary light reflex, but present accommodation reflex?
What is this caused by?
Argyll robertston pupil
Neurosyphilis
