Isocoria with Constricted
The precise location of the lesion is not known; presumably the
dis-order is due to a lesion is in the pretectal region and the
Edinger-Westphal nucleus such as tabes dorsalis (Argyll-Robertson phenomenon),
encephalitis, syringomyelia, trauma, bleeding, tumors, and alco-holism.
❖ Direct and consensual light reflexes are
❖Near reflex is intact or there is
overcompensation (the Edinger-Westphal nucleus is being controlled via the
❖The pupil is not round, and constriction is
not always symmetrical.
❖There is no reaction to darkness or
Bilateral Pupillary Constriction due to Pharmacologic Agents
❖Deep general anesthesia.
❖ Pilocarpine eyedrops.
Toxic Bilateral Pupillary Constriction
Inflammatory Bilateral Pupillary Constriction