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Anisocoria

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1. Transient anisocoria in a patient treated with nebulized ipratropium bromide (PubMed)

Transient anisocoria in a patient treated with nebulized ipratropium bromide We present a case report of a 44-year old female patient with complicated pneumonia who developed anisocoria after treatment with inhaled ipratropium bromide. Discontinuation of ipratropium bromide treatment led to complete resolution of anisocoria.A 44-year old female patient was admitted to the Department of Pulmonology due to high body temperature (40.0 °C), coughing and general weakness. After a general examination (...) discontinuing the ipratropium bromide treatment anisocoria was completely resolved.Presence of anisocoria may be a concerning neurological sign. If there are no other neurological or ophthalmological signs and symptoms and a recent ipratropium bromide inhalation treatment exists in the patient's history, we should consider iatrogenic side-effect of drugs as a possible reason of anisocoria and possibly spare the patient extensive and invasive diagnostic procedures that can also raise costs of treatment

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2017 American journal of ophthalmology case reports

2. Pharmacologic anisocoria due to nebulized ipratropium bromide: A diagnostic challenge. (PubMed)

Pharmacologic anisocoria due to nebulized ipratropium bromide: A diagnostic challenge. Anisocoria may be physiological or seen in fatal conditions, such as intracranial hemorrhage. Newly developing anisocoria may cause confusion and diagnostic difficulty in the emergency department (ED). A 35-year-old female was admitted to the ED with an asthma attack and dyspnea. On examination, the patient was observed to have bilateral rhonchi and was treated with nebulized albuterol (salbutamol (...) was diagnosed with pharmacologic anisocoria. The pupil returned to normal within 24 h. Ipratropium bromide is a drug frequently used in patients presenting to the ED with dyspnea. During treatment, nebulized ipratropium may leak from the edge of the facial mask into the ipsilateral eye and may cause mydriasis. A pilocarpine test can be used to differentiate pharmacological anisocoria from other causes, such as third nerve palsy and Adie's pupil. Through the awareness of emergency physicians and the use

2019 American Journal of Emergency Medicine

3. Physiologic anisocoria under various lighting conditions (PubMed)

Physiologic anisocoria under various lighting conditions To evaluate the measurement of anisocoria in a group of ocular healthy subjects using a standardized protocol in scotopic, mesopic, and photopic lighting conditions, and determine the optimal threshold of difference in pupil diameter in determining physiologic anisocoria.Right and left pupil diameters of 126 ocular healthy subjects with a mean age 30.5±7.8 years (40 males and 86 females) were measured sequentially under photopic (...) conditions using a monocular infrared pupillometer. A sub-group of 51 individuals had right and left pupil measurements performed under three additional lighting conditions, allowing for a 2-minute recovery between measurements. A white light emitting diode (LED) in the eyecup of the pupillometer produced three controlled light settings: scotopic (0 lux), low mesopic (0.3 lux), and high mesopic (3 lux). The criterion for anisocoria was defined as ≥0.4 mm difference in pupil diameter between the eyes.In

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2018 Clinical ophthalmology (Auckland, N.Z.)

4. Pupillary measurements and anisocoria in Chinese preschoolers 3-4 years of age screened using the plusoptiX A12C. (PubMed)

Pupillary measurements and anisocoria in Chinese preschoolers 3-4 years of age screened using the plusoptiX A12C. To evaluate the distribution of the pupil diameter and distance and the incidence of anisocoria in a screening setting for Chinese preschoolers 3-4 years of age.This was a cross-sectional, population-based study conducted in children aged 3-4 years in Nanjing, China. Plusoptix photoscreening was conducted without cycloplegia. Additional assessments were conducted, including light (...) reaction test, reevaluation for anisocoria (in dim and bright light), swinging-flashlight test, and cocaine test, if necessary.A total of 1,818 children were screened. Pupillary measurements were conducted successfully in nearly all children (99.3% for the pupil diameter; 98.4% for the interpupillary distance). The pupil diameters of both eyes of each individual were highly correlated (5.9 ± 0.7 mm in both eyes; P < 0.0001; r = 0.93). The mean interpupillary distance was 50.1 ± 3.1 mm. The pupil

2017 JAAPOS - Journal of the American Association for Pediatric Ophthalmology and Strabismus

5. Anisocoria Secondary to Anticholinergic Mydriasis from Homeopathic Pink Eye Relief Drops (PubMed)

Anisocoria Secondary to Anticholinergic Mydriasis from Homeopathic Pink Eye Relief Drops A woman, aged 70 years, developed anisocoria after applying homeopathic eye drops (Similasan Pink Eye Relief) to her left eye. Her pupil was dilated for two weeks and did not respond to light or near stimuli for one week. Both 0.1% and 1% pilocarpine failed to constrict her left pupil, and magnetic resonance imaging of her brain did not reveal any abnormality. The eye drops she had used contain belladonna (...) extracts which have a natural atropine component. This case demonstrates the importance, when evaluating a patient presenting with anisocoria, of knowing the chemical ingredients of the homeopathic eye drops, which often are not listed.© 2017 Marshfield Clinic.

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2017 Clinical medicine & research

6. Long-Term Follow-Up in Children with Anisocoria: Cocaine Test Results and Patient Outcome (PubMed)

Long-Term Follow-Up in Children with Anisocoria: Cocaine Test Results and Patient Outcome Evaluation of anisocoria including pharmacological testing for Horner's syndrome in the pediatric population is challenging in view of potential serious underlying disease. We describe cocaine test results, outcome of systemic investigation, and long-term follow-up in children with anisocoria.Retrospective review of medical records and phone interview of consecutive pediatric patients (<18 years old) who (...) trauma and surgical trauma. None of the other children further developed any pathology during the follow-up period of 34.8 months (range 0-106.6).In most children with anisocoria and a positive cocaine test result, systemic investigation did not reveal any underlying etiology. The only malignant disease was diagnosed in a patient with a suspicion of Horner's syndrome but with an inconclusive cocaine test result in our cohort.

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2017 Journal of ophthalmology

7. Anisocoria and an Array of Neurologic Symptoms in an Adult With Ewing Sarcoma (PubMed)

Anisocoria and an Array of Neurologic Symptoms in an Adult With Ewing Sarcoma 29900014 2018 11 14 2150-0878 8 1 2017 Jan-Feb Journal of the advanced practitioner in oncology J Adv Pract Oncol Anisocoria and an Array of Neurologic Symptoms in an Adult With Ewing Sarcoma. 18-23 LaRoche Mary Jane MJ University of Colorado Denver School of Medicine, Aurora, Colorado. eng Journal Article Review 2017 01 01 United States J Adv Pract Oncol 101550346 2150-0878 2018 6 15 6 0 2017 1 1 0 0 2017 1 1 0 1

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2017 Journal of the advanced practitioner in oncology

8. Anisocoria secondary to inadvertent contact with scopolamine patch (PubMed)

Anisocoria secondary to inadvertent contact with scopolamine patch A unilaterally fixed mydriasis, also known as a 'blown pupil,' is considered an ominous sign concerning for intracranial pathology. Causes of anisocoria can range from benign to immediately life-threatening. When a patient presents with anisocoria, the concern for a fatal diagnosis leads the clinician to obtain numerous tests, many of which may be unnecessary. The authors present a case of a healthy woman in her 30s who

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2017 BMJ case reports

9. Transient Anisocoria during Medial Blowout Fracture Surgery (PubMed)

Transient Anisocoria during Medial Blowout Fracture Surgery Transient anisocoria is rare during blowout fracture reconstruction. We report a case of transient anisocoria occurring during medial blowout fracture reconstruction and review the relevant literature. A 54-year-old woman was struck in the face and was admitted for a medial blowout fracture of the left eye. During the operation, persistent bleeding occurred. To control this bleeding, a 1% lidocaine solution with 1:200,000 epinephrine (...) and essential in ruling out any preexisting neurologic condition. Moreover, surgeons must be aware of the fact that excessive injection of lidocaine with epinephrine for hemostasis during orbital wall surgery can result in intraoperative anisocoria. Anisocoria-related situations must be addressed in a proficient manner through sufficient understanding of the mechanism controlling the pupillary response to various stimuli.

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2016 Archives of Craniofacial Surgery

10. Binocular summation and visual function with induced anisocoria and monovision (PubMed)

Binocular summation and visual function with induced anisocoria and monovision The advances in new techniques for correcting presbyopia, such as a small aperture combined with monovision, require an in-depth study of binocular aspects. In this work, we have studied binocular visual performance of 12 subjects after inducing different degrees of anisocoria combined with two different add powers in the non-dominant eye. We have analysed visual performance in terms of the visual-discrimination (...) capacity (a function to evaluate the strength of bothersome halos) and the contrast-sensitivity. The results show a deterioration of the binocular vision when inducing anisocoria and with any add power, with a higher perception of halos, a lower contrast sensitivity and poorer binocular summation of these visual functions on increasing anisocoria. This deterioration is clinically acceptable in the case of low add power, since positive binocular summation is maintained in contrast sensitivity

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2016 Biomedical optics express

11. Anisocoria

Anisocoria Anisocoria Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Anisocoria Anisocoria Aka: Anisocoria , Unequal Pupil From (...) Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Anisocoria." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Ontology: Anisocoria (C0003079) Definition (MSHCZE) Stav, kdy zornice obou očí nemají stejnou velikost. Může mít příčiny jak v oku samém, tak v nervovém systému. A. je důležitý příznak intrakraniálního krvácení, přičemž zornice na postižené straně

2018 FP Notebook

12. An approach to anisocoria. (PubMed)

An approach to anisocoria. Anisocoria is a finding seen on a daily basis in nearly every eye clinic. Although often benign, it can also represent the sole sign of a life-threatening disease making an up-to-date understanding of pathophysiology and diagnosis essential for anyone practicing medicine.Many aspects of the traditional approach to anisocoria still hold true today, but advancements in imaging technology and changing trends in pharmacologic diagnosis and localization have led many (...) to rethink that approach. In addition, the differential diagnosis for anisocoria continuously expands with identification and improved understanding of causal disease processes.The present article discusses an approach to the classic anisocoria diagnostic algorithm modified by current knowledge from the most recent literature.

2016 Current Opinion in Ophthalmology

13. Pupil to limbus ratio: Introducing a simple objective measure using two-box method for measuring early anisocoria and progress of pupillary change in the ICU (PubMed)

Pupil to limbus ratio: Introducing a simple objective measure using two-box method for measuring early anisocoria and progress of pupillary change in the ICU Measurement of static pupillary size in the ICU is of importance in cases of acutely expanding intracranial mass lesions. The inaccuracies with subjective assessment of pupillary size by medical personnel preclude its use in emergent neurological situations.To determine if the ratio of pupil to limbus diameter (PLD ratio) measured by a two (...) -box method is a reliable measure of pupil size for detecting early anisocoria and measuring pupillary changes.The PLD ratio was defined as the ratio of the pupillary diameter measured at a para-horizontal axial plane with the limbus diameter measured at the same or parallel axial plane. A two-box method was used to estimate the diameters of imaged pupils. Eyes were imaged using an iPhone 4S cellphone camera. Background illumination was measured and kept constant. The pupils of a 78-year-old woman

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2015 Journal of neurosciences in rural practice

14. A 15-year-old girl with variable anisocoria (PubMed)

A 15-year-old girl with variable anisocoria 25097459 2015 02 12 2018 11 13 1542-8958 20 1 2014 Digital journal of ophthalmology : DJO Digit J Ophthalmol A 15-year-old girl with variable anisocoria. 13-4 10.5693/djo.03.2013.10.001 Coleman Michael J MJ Department of Ophthalmology, Kresge Eye Institute, Wayne State University. Tomsak Robert L RL Department of Ophthalmology, Kresge Eye Institute, Wayne State University. eng Case Reports Journal Article 2014 01 01 United States Digit J Ophthalmol (...) 9605355 1542-8958 0 Muscarinic Antagonists V92SO9WP2I Glycopyrrolate IM Adolescent Anisocoria chemically induced Female Glycopyrrolate adverse effects Humans Hyperhidrosis drug therapy Muscarinic Antagonists adverse effects 2014 8 7 6 0 2014 8 7 6 0 2015 2 13 6 0 epublish 25097459 10.5693/djo.03.2013.10.001 djo-12-029 PMC4120786 BMJ. 2000 May 6;320(7244):1221-2 10797017 Headache. 2003 Apr;43(4):416-8 12656717 J Am Acad Dermatol. 2004 Aug;51(2):241-8 15280843 J Clin Neuroophthalmol. 1987 Mar;7(1):34-7

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2014 Digital Journal of Ophthalmology : DJO

15. Sudden-onset anisocoria in a patient with upper respiratory tract infection (PubMed)

Sudden-onset anisocoria in a patient with upper respiratory tract infection 24218537 2014 03 03 2018 11 13 1488-2329 186 1 2014 Jan 07 CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne CMAJ Sudden-onset anisocoria in a patient with upper respiratory tract infection. 57-61 10.1503/cmaj.130581 Furlan Julio C JC Sundaram Arun N E AN eng Case Reports Journal Article 2013 11 11 Canada CMAJ 9711805 0820-3946 0 Antiplatyhelmintic Agents AIM IM CMAJ. 2014 Jun (...) 10;186(9):697 24914229 Adult Anisocoria diagnosis etiology Antiplatyhelmintic Agents therapeutic use Carotid Artery, Internal, Dissection complications diagnosis drug therapy etiology Diagnosis, Differential Female Horner Syndrome diagnosis etiology Humans Prognosis Respiratory Tract Infections complications 2013 11 13 6 0 2013 11 13 6 0 2014 3 4 6 0 ppublish 24218537 cmaj.130581 10.1503/cmaj.130581 PMC3883825 Int J Stroke. 2007 Nov;2(4):292-6 18705933 N Engl J Med. 2001 Mar 22;344(12):898-906

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2014 CMAJ : Canadian Medical Association Journal

16. Tournay's description of anisocoria on lateral gaze: Reaction, myth, or phenomenon? (PubMed)

Tournay's description of anisocoria on lateral gaze: Reaction, myth, or phenomenon? The year 1917 witnessed the opening of a great debate in neuro-ophthalmology, with Tournay's description of a phenomenon thought to be universal: anisocoria in lateral gaze, due to mydriasis of the abducting pupil and a minor miosis of the fellow one. Through many publications, this phenomenon was soon assessed and confirmed to be physiologic, while the cause of the pupil reaction in lateral gaze was extensively (...) to help unfold the controversy; anisocoria in lateral gaze should not be regarded as a myth, nor does it--or only rarely--correspond to a pupil reaction, or noumenon: it can usually be accounted for by a specific optical distortion (apparent without real anisocoria) and hence fits the Kantian definition of a phenomenon. An understanding of Tournay phenomenon is therefore of current relevance to the examination of the pupils to avoid misinterpretation of observed changes in the pupil.

2014 Neurology

17. Anisocoria (Follow-up)

Anisocoria (Follow-up) Anisocoria Treatment & Management: Medical Care, Surgical Care, Consultations Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE1ODU3MS10cmVhdG1lbnQ= processing > Anisocoria Treatment (...) & Management Updated: Dec 27, 2018 Author: Eric R Eggenberger, DO, MS, FAAN; Chief Editor: Edsel Ing, MD, MPH, FRCSC Share Email Print Feedback Close Sections Sections Anisocoria Treatment Medical Care Medical care depends upon the underlying pathophysiology. If the patient has unequal accommodation, reading glasses or bifocals may be required. If the patient has mydriasis and glare, dilute pilocarpine, sunglasses, or FL-41 lenses may be beneficial. Next: Surgical Care Surgical care depends upon

2014 eMedicine.com

18. Anisocoria (Follow-up)

Anisocoria (Follow-up) Anisocoria Treatment & Management: Medical Care, Surgical Care, Consultations Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE1ODU3MS10cmVhdG1lbnQ= processing > Anisocoria Treatment (...) & Management Updated: Dec 27, 2018 Author: Eric R Eggenberger, DO, MS, FAAN; Chief Editor: Edsel Ing, MD, MPH, FRCSC Share Email Print Feedback Close Sections Sections Anisocoria Treatment Medical Care Medical care depends upon the underlying pathophysiology. If the patient has unequal accommodation, reading glasses or bifocals may be required. If the patient has mydriasis and glare, dilute pilocarpine, sunglasses, or FL-41 lenses may be beneficial. Next: Surgical Care Surgical care depends upon

2014 eMedicine.com

19. Anisocoria (Overview)

Anisocoria (Overview) Anisocoria: Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE1ODU3MS1vdmVydmlldw== processing > Anisocoria Updated: Dec 27, 2018 Author: Eric R (...) Eggenberger, DO, MS, FAAN; Chief Editor: Edsel Ing, MD, MPH, FRCSC Share Email Print Feedback Close Sections Sections Anisocoria Overview Background Anisocoria, or unequal pupil sizes, is a common condition. The varied causes have implications ranging from life-threatening to completely benign, and a clinically guided history and examination is the first step in establishing a diagnosis. Next: Pathophysiology Pupil size depends on the effects of the autonomic nervous system and the iris muscle

2014 eMedicine.com

20. Anisocoria (Overview)

Anisocoria (Overview) Anisocoria: Background, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE1ODU3MS1vdmVydmlldw== processing > Anisocoria Updated: Dec 27, 2018 Author: Eric R (...) Eggenberger, DO, MS, FAAN; Chief Editor: Edsel Ing, MD, MPH, FRCSC Share Email Print Feedback Close Sections Sections Anisocoria Overview Background Anisocoria, or unequal pupil sizes, is a common condition. The varied causes have implications ranging from life-threatening to completely benign, and a clinically guided history and examination is the first step in establishing a diagnosis. Next: Pathophysiology Pupil size depends on the effects of the autonomic nervous system and the iris muscle

2014 eMedicine.com

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