Isocoria with Dilated Pupils
Tumors such as pineal gland tumors that selectively damage fibersbetween the pretectal nuclei and the Edinger-Westphal nucleus.
❖ Fixed dilated pupils that do not respond to light.
❖ Normal near reflex.
❖ Limited upward gaze (due to damage to the vertical gaze center) and retraction nystagmus.
Atropine, spasmolytic agents, anti-parkinson agents, antidepres-sants, botulism (very rare but important), carbon monoxide, cocaine.
❖ Epileptic seizure.
❖ Increased sympathetic tone (Bumke’s anxiety pupils).