Article Figures & Data
Figures
- Figure Flow Diagram for the Evaluation of Anisocoria
(1) Size of the pupils indicated is only a representative measure and does not indicate the absolute pupil size for a patient seen clinically. (2) If the light reflex is absent or poor, the presence or absence of the near reflex must be assessed. (3) Post-test anisocoria >0.8 mm indicates a positive result. (4) Result should be assessed at a minimum of 45 minutes after instilling apraclonidine. Positive test is indicated by a reversal of anisocoria and improvement of ptosis. (5) Can be positive in a preganglionic cranial nerve III palsy. (6) Light–near pupil dissociation and segmental paresis of iris sphincter muscle (vermiform movement). (7) Cranial nerve III palsy will also manifest with upper eyelid ptosis and external ophthalmoplegia. (8) Pupil may react to 1%–2% pilocarpine if the muscarinic blocking activity of the offending agent is wearing off. Reproduced with permission from Bhatti MT, Schmalfus I. Handbook of Neuroimaging for the Ophthalmologist. London, UK: JP Medical Publishers Ltd; 2014.
Tables
Video 1
A 65-year-old woman with a chronic miotic Adie pupil. The left pupil responds poorly to light but briskly to near stimulation. Following near stimulation, the pupil constricts, followed by a slow dilation. Infrared recording shows an irregularly shaped pupil with poor movement of the temporal and inferior segments of the iris margin.Download Supplementary Video 1 via http://dx.doi.org/10.1212/011221_Video_1
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