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Anisocoria

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21. Anisocoria (Diagnosis)

Anisocoria (Diagnosis) 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

22. Anisocoria (Diagnosis)

Anisocoria (Diagnosis) 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

23. Anisocoria (Treatment)

Anisocoria (Treatment) 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

24. Anisocoria (Treatment)

Anisocoria (Treatment) 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

25. Pupil Size and anisocoria in children measured by the plusoptiX photoscreener. (PubMed)

Pupil Size and anisocoria in children measured by the plusoptiX photoscreener. To investigate pupil size and the incidence of anisocoria in children at a single community-based practice using the plusoptiX A04 and A09 photoscreeners (plusoptiX GmbH, Nuremberg, Germany).The medical records of consecutive patients <1 to 17 years of age who had received a comprehensive ophthalmological examination that included photoscreening with the plusoptiX were retrospectively reviewed. Data collected (...) included sizes of both pupils, age, sex, laterality, and magnitude of anisocoria.A total of 1,306 patient records were reviewed. Of these, 1,057 (80.9%) had 0-0.4 mm of anisocoria; 219 (16.8%), 0.5-0.9 mm; 20 (1.5%), 1.0-1.4 mm; and 10 (0.8%), ≥1.5 mm. Magnitude of anisocoria appears to increase with age (P = 0.0073). Pupil size and age were positively correlated (P < 0.0001), that is, older children had larger pupils. Average pupil size of children <1 year of age was 5.0 mm; of children ≥16 years

2013 JAAPOS - Journal of the American Association for Pediatric Ophthalmology and Strabismus

26. Studying the Effect of Iris Mechanics on the Pupillary Light Reflex Using Brimonidine Induced Anisocoria. (PubMed)

Studying the Effect of Iris Mechanics on the Pupillary Light Reflex Using Brimonidine Induced Anisocoria. To study and correct for the limiting effect of iris mechanics on the amplitude of light-evoked pupil contractions in order to derive a more clinically accurate assessment of afferent input to the visual system.Transient pupil responses were recorded to a series of 1-second red Ganzfeld light stimuli with a stepwise increase in stimulus intensity using a binocular infrared computerized

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2013 Investigative Ophthalmology & Visual Science

27. 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

2015 FP Notebook

28. Contraction anisocoria: segregation, summation and saturation in the pupillary pathway. (PubMed)

Contraction anisocoria: segregation, summation and saturation in the pupillary pathway. To investigate the neural basis of contraction anisocoria and any implications for assessments using pupillary responses, through analysis of topographic variation in amplitudes of direct and consensual pupil responses.Direct and consensual pupillary contraction amplitudes were analyzed from six studies in which 120 normal subjects were tested with 24 different stimulus variants. The dichoptically presented

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2011 Investigative Ophthalmology & Visual Science

29. Transient anisocoria: A pesky palpitation (PubMed)

Transient anisocoria: A pesky palpitation 21897703 2013 07 04 2018 11 13 0976-3155 2 2 2011 Jul Journal of neurosciences in rural practice J Neurosci Rural Pract Transient anisocoria: A pesky palpitation. 210-1 10.4103/0976-3147.83606 Senthilkumaran Subramanian S Department of Emergency and Critical Care Medicine, Sri Gokulam Hospital and Research Institute, Salem, India. Balamurugan N N Suresh P P Thirumalaikolundusubramanian P P eng Journal Article India J Neurosci Rural Pract 101533710 0976

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2011 Journal of neurosciences in rural practice

30. Pupillary Studies, with Special Reference to Anisocoria (PubMed)

Pupillary Studies, with Special Reference to Anisocoria 16692421 2006 06 01 2008 11 20 0065-9533 15 1917 Transactions of the American Ophthalmological Society Trans Am Ophthalmol Soc Pupillary Studies, with Special Reference to Anisocoria. 301-24 Tarun W W eng Journal Article United States Trans Am Ophthalmol Soc 7506106 0065-9533 1917 1 1 0 0 1917 1 1 0 1 1917 1 1 0 0 ppublish 16692421 PMC1318127

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1917 Transactions of the American Ophthalmological Society

31. Anisocoria

Anisocoria Anisocoria - Eye Disorders - MSD Manual Professional Edition Brought to you by The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases The trusted provider of medical information since 1899 SEARCH SEARCH MEDICAL TOPICS Common Health Topics Resources QUIZZES & CASES Quizzes Cases / / / / IN THIS TOPIC OTHER TOPICS IN THIS CHAPTER Test your knowledge Blurred Vision Blurred vision, accompanied (...) SOCIAL MEDIA Add to Any Platform Loading , MD, Wilmer Eye Institute, Retina Division, Johns Hopkins University School of Medicine Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Topic Resources Anisocoria due to Horner Syndrome © Springer Science+Business Media Anisocoria is unequal pupil sizes. Anisocoria itself does not cause symptoms. Etiology The most common cause of anisocoria is Physiologic (present in about 20% of people): The difference between pupil sizes

2013 Merck Manual (19th Edition)

32. Wernicke's encephalopathy

concentration, and apathy frank confusion hx of GI surgery ocular motor findings mental status changes, ophthalmoplegia, and gait dysfunction alcohol dependence pre-existing conditions that predispose to malnutrition: for example, AIDS, cancer, prolonged vomiting, or diarrhoea mild irritability delirium acute psychosis coma miosis, anisocoria, light-near dissociation papilloedema, retinal haemorrhages tachycardia or hypotension hypothermia or hyperthermia hearing loss, seizures, and spastic paraparesis

2018 BMJ Best Practice

33. Guillain-Barre syndrome

(Baltimore). 1969 May;48(3):173-215. http://www.ncbi.nlm.nih.gov/pubmed/5769741?tool=bestpractice.com History and exam presence of risk factors muscle weakness respiratory distress speech problems paraesthesia back/leg pain areflexia/hyporeflexia facial weakness bulbar dysfunction causing oropharyngeal weakness extra-ocular muscle weakness facial droop diplopia dysarthria dysphagia dysautonomia anisocoria non-reactive pupil ophthalmoplegia ptosis altered level of consciousness ataxia preceding viral

2018 BMJ Best Practice

34. Guillain-Barre syndrome

(Baltimore). 1969 May;48(3):173-215. http://www.ncbi.nlm.nih.gov/pubmed/5769741?tool=bestpractice.com History and exam presence of risk factors muscle weakness respiratory distress speech problems paraesthesia back/leg pain areflexia/hyporeflexia facial weakness bulbar dysfunction causing oropharyngeal weakness extra-ocular muscle weakness facial droop diplopia dysarthria dysphagia dysautonomia anisocoria non-reactive pupil ophthalmoplegia ptosis altered level of consciousness ataxia preceding viral

2018 BMJ Best Practice

35. CRACKCast E022 – Red and Painful Eye

) Hyperthyroidism (enlarged ocular muscles) Orbital emphysema or inflammation (retained foreign body) What are the causes of enophthalmos? Contralateral proptosis Penetrating globe injury causing vitreous extrusion 2) How to differentiate between bacterial vs. viral conjunctivitis? Still NO good evidence exists to distinguish between the two Weak positive LR of 3.1 for bacterial IF Sticking eyelids in the AM plus mucoid/purulent discharge 3) What are the causes of Anisocoria? Previous eye trauma Globe injury

2017 CandiEM

36. CRACKCast E071 – Ophthalmology Part A

despite blindness 2) Malingerer: usually overly emotional reaction to vision loss Normal pupillary reflexes, no RAPD, normal fundoscopy Test: Hesitant to oppose index fingers Write their names in an obviously disorderly fashion (a blind person can write their names neatly) Mirror test: having the person follow their eyes as the mirror is tilted Optokinetic nystagmus 20) List 5 DDx for anisocoria. Which are greater in dark, and which are greater in light? Anisocoria Clinical features: In the setting (...) of trauma or dec. LOC : requires immediate neuro-imaging or intervention — > inc. ICP In lighted setting: the problem pupil is the LARGER one In a dark setting: the problem is the the SMALLER one In a normal afferent visual system – there is likely an iris defect Can occur in the setting of seizures as well Condition ADIE’s Tonic pupil syndrome Pharm. induced Mydriasis Third Nerve palsy Physiologic anisocoria Horner’s syndrome Clinical features blurred near vision, normal far vision. young women – 70

2017 CandiEM

37. CRACKCast E020 – Headaches

Congenital or skull abnormalities Post partum or peri-partum Epidural hematoma -traumatic injury -Lucid→ somnolent -anisocoria According to Rosen’s: “The most common and consequential mistake made by ERP’s: is thinking that a single CT head clears the patient of the possibility of a SAH or other intracranial disease” Brain CT can miss 6-8% of patients with a SAH (esp. The minor GRADE 1 class) CT sensitivity for SAH (http://www.bmj.com/content/343/bmj.d4277) Decreases by 10% for symptom onset > 12 hrs

2016 CandiEM

38. CRACKCast E041 – Head Injury

pupils Cerebellar-Tonsillar herniation Due to cerebellar tonsils herniating through the foramen magnum Cerebellar mass or large central vertex mass Signs: Sudden resp / cardio collapse, pinpoint pupils, flaccid quadriplegia ( corticospinal tracts are compressed) Describe the pathophysiology of uncal herniation and the typical presentation. See Rosen’s Figure 41-5 in Head Injury Chapter Signs: Anisocoria, ptosis, impaired EOMs, sluggish pupil on the IPsilateral side A dilated, non-reactive pupil

2016 CandiEM

39. Vertical diplopia and oscillopsia due to midbrain keyhole aqueduct syndrome associated with severe cough (PubMed)

revealed a 1-2 Hz down-beating nystagmus in primary gaze that worsened with left, right, and down gazes. Gaze evoked nystagmus and mild paresis were also seen with up gaze. There was an incomitant left hypertropia due to skew deviation that worsened with right and up gazes and improved with down gaze. She also had a right-sided ptosis and a 3 mm anisocoria not due to cranial nerve 3 paresis or Horner's syndrome. Brain magnetic resonance imaging showed a 1.5 mm × 11.7 mm × 6 mm midline cleft

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2018 American journal of ophthalmology case reports

40. Endoscopic hematoma evacuation for acute subdural hematoma in a young patient: a case report (PubMed)

and tips.A 31-year-old man was found to be in a state of general convulsion. At the time of admission, we observed severe consciousness disturbance, anisocoria, and left hemiparesis. Computed tomography showed a massive subdural hematoma with marked midline shift.Osmotherapy and emergency trepanation improved anisocoria. An endoscopic procedure under local anesthesia was sequentially selected. After surgery, the patient's symptoms clearly improved.Although the standard treatment for ASDH is craniotomy

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2017 Acute medicine & surgery

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