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Chapter: Ophthalmology: Pupil

Isocoria with Constricted Pupils

Causes: The precise location of the lesion is not known; presumably the dis-order is due to a lesion is in the pretectal region.

Isocoria with Constricted Pupils



Argyll-Robertson Pupil

Causes: 

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, diffuse encephalitis, syringomyelia, trauma, bleeding, tumors, and alco-holism.

Diagnostic considerations:

Direct and consensual light reflexes are absent.

Near reflex is intact or there is overcompensation (the Edinger-Westphal nucleus is being controlled via the convergence center).

The pupil is not round, and constriction is not always symmetrical.

There is no reaction to darkness or pharmacologic stimuli.

Bilateral Pupillary Constriction due to Pharmacologic Agents

Causes:

Morphine.

Deep general anesthesia.

Pilocarpine eyedrops.

Toxic Bilateral Pupillary Constriction

Causes: 

Mushroom poisoning.

Inflammatory Bilateral Pupillary Constriction

Causes:

Encephalitis.

Meningitis.

 

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Ophthalmology: Pupil : Isocoria with Constricted Pupils |


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