Pupillary abnormalities

Question 1

Tonic pupil (Adie’s Pupil)

Answer 1

Pupil is large, regular, and usually unilateral. reaction to light is severely reduced and slowed, or even absent. Near reaction, although very slow, is present. slow accomodation causes blurred vision. decreased dtr
Adie syndrome presents with 3 hallmark symptoms: at least one dilated pupils (mydriasis) which does not constrict to light, loss of DTR, and diaphoresis. Result of a viral or bacterial infection of the parasympathetic nerve of the eye can also affect the dorsal root of the spinal cord causing symptoms lower in the body.

Question 2

Oculomotor nerve paralysis (CN3)

Answer 2

the dilated pupil is fixed to light and near effort. Ptosis of upper eyelid and lateral deviation of the eye are almost always present

Question 3

Horner’s syndrome

Answer 3

affected pupil, though small, reacts briskly to light and near effort, ptsosis of eyelid is present, perhaps with loss of sweating on the forehead. Indicates a problem with the sympathetic nervous system.

Question 4

small, irregular pupils

Answer 4

small irregular pupils that accommodate but do not react to light indicate argyll robertson pupils. seen in cns syphillis

Question 5

equal pupils and one blind eye

Answer 5

a light directed in the seeing eye produces a direct reaction in that eye and a consensual reaction in the blind eye. a light directed in the blind eye, causes no response in either eye