7 - Opth - Pupillary reflexes - Constricted pupil Flashcards Preview

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Flashcards in 7 - Opth - Pupillary reflexes - Constricted pupil Deck (9):
1

2 causes of constricted pupil

Horners syndrome
Argyll roberston pupils

2

What causes Horners (generally)

damage to sympathetic trunk

3

Causes of horners in 1st order neurones

brainstem disease, SC lesions, diabetic autonomic neuropathy

4

Causes of horners in 2nd order neurones

pancoast tumour, carotid/aortic aneurysm/dissection, neck lesions/trauma

5

Causes of horners in 3rd order neurones

cluster headaches, internal artery dissection, otitis media, cavernous sinus mass

6

Mechanism of constriction in Horners

impaired dilatation
so - unopposed constriction

7

Signs of horners

pupil constriction
slight ptosis (weakened mullers muscle)
anhydrosis on affected side (IF lesion below superior cervical ganglion)

8

When do argyll robertson pupils occur

tertiary syphilis -> brainstem lesion - usually bilateral

9

Features of argyll robertson pupils

pupils small and irregular
sluggishly reactive
light near dissociation (accomodate but minimally reactive)

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