Home | | Ophthalmology | Anisocoria with a Constricted Pupil in the Affected Eye

Chapter: Ophthalmology: Pupil

Anisocoria with a Constricted Pupil in the Affected Eye

Causes: Damage to the sympathetic pathway.

Anisocoria with a Constricted Pupil in the Affected Eye


Horner’s Syndrome

Causes: 

Damage to the sympathetic pathway.

Central (first neuron):

–  Tumors.

–  Encephalitis.

–  Diffuse encephalitis.

Peripheral (second neuron):

–  Syringomyelia.

–  Diffuse encephalitis.

–  Trauma.

–  Rhinopharyngeal tumors.

–  Goiter.

–  Aneurysm.

–  Processes in the tip of the lung.

Peripheral in the strict sense (third neuron):

–  Vascular processes.

–  Internal carotid aneurysm.

Clinical Picture:

Miosis (approximately 1 – 2 mm difference) due to failure of the dilator pupillae muscle.

Ptosis (approximately 1 – 2 mm difference) due to failure of the muscle of Müller.

Enophthalmos due to failure of the rudimentary lower eyelid retractors. This makes the lower eyelid project so that the eye appears smaller. This condition only represents a type of pseudoenophthalmos.

Decreased sweat gland secretion (only present in preganglionic disorders as the sweat glands receive their neural supply via the eternal carotid).

Diagnostic considerations:

Direct and consensual light reflexes are intact, which distinguishes this disorder from a parasympathetic lesion); the pupil dilates more slowly (dilation deficit).

Near reflex is intact.

Pharmacologic testing with cocaine eyedrops:

Peripheral Horner’s syndrome:On the affected side, there is slight mydriasis (decrease in norepinephrine due to nerve lesion). On theunaffected side, there is significant mydriasis.

Central Horner’s syndrome:On the affected side, the pupil is dilated. Onthe unaffected side, the pupil is also dilated (the norepinephrine in thesynapses is not inhibited).

Following Eyedrop Application (Unilateral Administration of a Miotic as in Glaucoma Therapy)

 

Study Material, Lecturing Notes, Assignment, Reference, Wiki description explanation, brief detail
Ophthalmology: Pupil : Anisocoria with a Constricted Pupil in the Affected Eye |


Privacy Policy, Terms and Conditions, DMCA Policy and Compliant

Copyright © 2018-2023 BrainKart.com; All Rights Reserved. Developed by Therithal info, Chennai.