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61. A Case of Synchronised Pupillary and Nasal Cycling: Evidence for a Central Autonomic Pendulum? (PubMed)

A Case of Synchronised Pupillary and Nasal Cycling: Evidence for a Central Autonomic Pendulum? We previously reported that some healthy individuals show alternating anisocoria. We now describe one such individual who also exhibits a classic nasal cycle (alternating periods of nasal congestion and decongestion). We made measurements of his pupil asymmetry and nasal asymmetry at 21 different time points and found that these variables were always synchronised such that greater nasal airflow

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2017 Neuro-Ophthalmology

62. Pupillary abnormalities in non-selected critically ill patients: an observational study (PubMed)

study in a medical university affiliated ICU over a 6-month period. All patients with at least one pupillary examination were included. PA was defined as areflexia and/or anisocoria present at the time of ICU admission or occurring during the ICU stay.During the study period, we included 297 patients who had 6±9 pupillary examinations per day (totaling 11,360 pupillary assessments). The majority of patients (n=161, 54%) were admitted to the ICU for acute respiratory or cardiovascular failure (...) . A total of 128 PAs were recorded in 109 patients: 78 areflexia alone (61%), 33 anisocoria alone (26%) and 17 (13%) with associated anisocoria and areflexia. The main causes of PAs were related to acute brain ischemia (n=41, 32%) and sedation/analgesia (n=50, 39%). Among the PAs, 59 (46%) were present upon ICU admission. The etiologies of the PAs at admission did not differ from those occurring during ICU stay (P=NS). Interestingly, 9 (7%) PAs were attributed to ipratropium nebulization in patients

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2017 Journal of thoracic disease

63. Reverse Locked-In Syndrome (PubMed)

pupillary and oculomotor paralysis. MRI revealed infarction of the bilateral oculomotor nuclei in the midbrain tegmentum. At 9-month follow-up, he had anisocoria and dysconjugate gaze, but was living at home and required minimal assistance in performing all activities of daily living.Since the patient's deficits were the exact opposite of those described in locked-in syndrome, we propose the term "reverse locked-in syndrome" to describe this neurological entity characterized by bilateral ptosis, non

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2017 Neurocritical care

64. Pupil size in refractive surgery candidates. (PubMed)

Pupil size in refractive surgery candidates. To assess pupil size measurements obtained under scotopic and mesopic conditions with the Procyon pupillometer and under photopic conditions with the Humphrey videokeratographer.The pupil sizes of 96 candidates for refractive surgery (192 eyes) were measured with the Procyon pupillometer PS2000 SA and the Humphrey Atlas 992 corneal topographer. Anisocoria and pupillary unrest were analyzed according to gender (two groups: 51 females and 45 males

2017 Journal of Refractive Surgery

65. Dental local anaesthesia and ophthalmic side effects

Diplopia Endophthalmitis Globe penetration Horner syndrome Impaired visual acuity (blurred vision) Strabismus (convergent or divergent) Loss of accommodation (cycloplegia) Mydriasis (dilation of the pupil) Ophthalmoplegia (internal or external, partial or total) Ptosis 92% were transient – of these 25% took 6 hours to resolve. 8% caused permanent functional damage, either as vision deficit or anisocoria (two pupils are not of equal size). 46 were reported with maxillary injections, 42 with mandibular

2016 The Dental Elf

66. Delayed Acute Subdural Hematoma Associated With Percutaneous Coronary Intervention (PubMed)

arrhythmia. She had hit her head on the road. The initial CT did not reveal any hemorrhage in the intra-cranium. She fully recovered after PCI. However, 1 hour after PCI, she lost consciousness and immediate CT showed acute subdural hematoma and subarachnoid hemorrhage. The period from losing consciousness to brain herniation presenting as anisocoria was very short-only 30 minutes in our patient. Although emergent evacuation of hematoma and external decompression were performed, the patient died 1 day

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2016 The Journal of craniofacial surgery

67. Digital Pupillometry in Normal Subjects (PubMed)

. The absolute linear camera resolution was approximately 20 pixels per mm. This cross-sectional study analysed 490 eyes of 245 subjects (mean age: 51.9 ± 18.3 years, range: 6-87 years). On average, pupil diameter decreased with increasing light intensities for both eyes, with a mean pupil diameter of 5.39 ± 1.04 mm at 0 lux, 5.20 ± 1.00 mm at 0.5 lux, 4.70 ± 0.97 mm at 4 lux, 3.74 ± 0.78 mm at 32 lux, and 2.84 ± 0.50 mm at 250 lux illumination. Furthermore, it was found that anisocoria increased by 0.03 mm (...) per life decade for all illumination levels (R2 = 0.43). Anisocoria was higher under scotopic and mesopic conditions. This study provides additional information to the current knowledge concerning age- and light-related pupil size and anisocoria as a baseline for future patient studies.

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2016 Neuro-Ophthalmology

68. Performance of a Photoscreener for Vision Screening in a Haitian Pediatric Population

in front him. The spot then evaluates for refractive errors, anisocoria, strabismus, ptosis and media opacity. The ophthalmologic evaluation consists of the measure of the visual acuity, ocular alignment, anterior and posterior segment. The patient will be cyclopleged with cycloplegic drops and will be refracted to obtain a cyclopleged refraction. This will determine his refractive error. Device: Spot photoscreener Screening of vision problem through an automated device Procedure: Ophthalmologic

2016 Clinical Trials

69. Pupillometry Dynamic Measures in Patients Without Ocular or Neurological Disease

disease Ametropia inferior to 3 diopters for spherical correction and inferior to 1.50 diopter for astigmatism correction Matched for age and sex with one of the 22 subjects of the patients' unilateral NORB database Exclusion Criteria: history of disease affecting pupillary motility anisocoria patient under legal protection pregnant or breast feeding patient patient's refusal to participate in the study no medical insurance coverage Contacts and Locations Go to Information from the National Library

2016 Clinical Trials

70. Underestimation of Pupil Size by Critical Care and Neurosurgical Nurses. (PubMed)

of critical care and neurosurgical nurses' assessments of pupils was determined. The study included assessment of drawings of eyes with an iris and pupil, examination of photographs of human eyes, and bedside examination of patients with a head injury.Subjective assessments of pupil diameter and symmetry were not accurate. Across all phases of the study, pupil diameters were underestimated and the rate of error increased as pupil size increased. Nurses also failed to detect anisocoria and misidentified (...) pupil reactivity. In addition, nearly all nurses relied on subjective estimation, even when tools were available.Critical care and neurosurgical nurses underestimated pupil size, were unable to detect anisocoria, and incorrectly assessed pupil reactivity. Standardized use of pupil assessment tools such as a pupillometer is necessary to increase accuracy and consistency in pupil measurement and to potentially contribute to earlier detection of subtle changes in pupils. If pupillary changes

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2016 American Journal of Critical Care

71. Tonic pupil after botulinum toxin-A injection for treatment of esotropia in children. (PubMed)

3 cases occurred in the left eye of participants who underwent bilateral BTX-A injection by the same surgeon. Anisocoria diminished from a maximum of 4 mm at the 2-week visit to 1-2 mm in all patients over the 9-month postinjection data collection period. No adverse visual outcomes were noted. Tonic pupil is an infrequently reported complication of BTX-A injection for strabismus. The experience of our investigator group suggests the need for careful injection technique and thorough preinjection

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2016 JAAPOS - Journal of the American Association for Pediatric Ophthalmology and Strabismus

72. A Rare Case of Penetrating Trauma Resulting in Isolated Third Nerve Palsy (PubMed)

of a traumatic injury were present. The patient was observed for 14 months, during which he continually improved, with almost complete resolution of his diplopia, anisocoria, and ptosis.

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2016 Neuro-Ophthalmology

73. Reliability of standard pupillometry practice in neurocritical care: an observational, double-blinded study (PubMed)

condition with NeuroLight Algiscan pupillometer. During another period, we conducted a prospective, observational, double-blinded study in two neurocritical care units. Patients admitted to these units after an acute brain injury were included. Initially, nursing staff measured pupil size, anisocoria and pupillary light reflex. A blinded physician subsequently performed measurement using an automated pupillometer.In 200 healthy volunteers, intra-class correlation coefficient for maximum resting pupil (...) , IC: 0.70-0.79; P < 0.001). Nursing staff failed to diagnose half of the cases (15/30) of anisocoria detected using the pupillometer device. A global rate of discordance of 18% (72/406) was found between the two techniques when assessing the pupillary light reflex. For measurements with small pupils (diameters <2 mm) the error rate was 39% (24/61).Standard practice in pupillary monitoring yields inaccurate data. Automated quantitative pupillometry is a more reliable method with which to collect

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2016 Critical Care

74. The Effect of Brimonidine on Intraocular Pressure When Dilating Routine Patients

Accepts Healthy Volunteers: Yes Criteria Inclusion Criteria: Healthy with no major medical conditions. Contact lens wear is ok but must be not worn on the day of the study Exclusion Criteria: Diabetic, history of glaucoma history of iris trauma history of eye surgery except LASIK or Photorefractive keratectomy laser eye surgery Anisocoria pregnancy Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study

2016 Clinical Trials

75. Ophthalmologic complications after administration of local anesthesia in dentistry: a systematic review. (PubMed)

experiencing ocular adverse events after administration of dental local anesthesia have been reported in the literature. Most of the complications manifested as double vision. Only 8% of the complications caused permanent functional damage, either as vision deficit or anisocoria. Complete permanent blindness was not reported.Ocular complications as a result of dental local anesthesia may be seen as rare occurrences with usually low intensity. However, visual function may become permanently impaired

2016 Oral surgery, oral medicine, oral pathology and oral radiology

76. Brown-Séquard syndrome without vascular injury associated with Horner's syndrome after a stab injury to the neck (PubMed)

and optimizing function after Brown-Séquard spinal cord injury are important roles for the rehabilitation team. Imaging is necessary to rule out cord hemorrhage or vascular injury and to clinically correlate cord damage with physical examination findings and expected functional impairments. Documenting associated anisocoria and explaining this finding to the patient is an important element of spinal cord injury education. Commonly, patients with Brown-Séquard injuries demonstrate remarkable motor recovery

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2016 The journal of spinal cord medicine

77. “Don't Believe Your Eyes” Ipratropium Induced Mydriasis: A Case Report and Review of the Literature (PubMed)

“Don't Believe Your Eyes” Ipratropium Induced Mydriasis: A Case Report and Review of the Literature Unilateral fixed mydriasis can be an ominous sign; however in many cases, it is benign and represents pharmacologic mediated action on the iris dilator or sphincter. Differentiation between pharmacologic mediated anisocoria and physiologic anisocoria can be challenging but may save on costly imaging. An 83 year-old woman was admitted with critical limb ischemia and subsequently developed (...) respiratory failure treated with positive pressure ventilation and ipratropium nebulizers. She was noted to have left unilateral mydriasis without other neurologic deficits. Brain magnetic resonance imaging with MR angiography showed no evidence for a mass lesion or posterior communicating artery aneurysm. Her anisocoria self-resolved within 36 hours after nebulizer treatments were stopped. Ipratropium bromide is one of the most common medications used in the hospital setting and should be consider

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2016 General medicine (Los Angeles, Calif.)

78. Emergency decompressive craniectomy after removal of convexity meningiomas (PubMed)

and pupillary anisocoria. Computed tomography revealed no postoperative hematoma, however, did indicate increased brain edema and ventricular shift (mean: 12 mm). Emergency decompressive craniectomy and brief ventilator assistance were performed in all patients. Ischemia of the ipsilateral posterior cerebral artery occurred in 3 patients and hydrocephalus occurred in 2 patients. Outcome was good in 2, fair in 2, 1 patient had severe disability, and 1 patient died after 8 months.Brain shift on preoperative

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2016 Surgical neurology international

79. A Rare Case in the Emergency Department: Holmes-Adie Syndrome (PubMed)

is the absence of deep tendon reflexes, and unilateral involvement is more common. This case report emphasizes that HAS should be considered in the differential diagnosis of patients presenting to the emergency department with anisocoria, and the dilute pilocarpine test can be used in diagnosis.

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2016 Turkish journal of emergency medicine

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