Anisocoria
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| Anisocoria Classification and external resources | |
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| Anisocoria | |
| ICD-10 | H57.0 |
| ICD-9 | 379.41 |
| OMIM | 106240 |
| DiseasesDB | 724 |
| eMedicine | emerg/29 neuro/479 oph/160 |
| MeSH | D015875 |
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Anisocoria is a condition characterized by an unequal size of the pupils.
Causes
To a certain extent, this is normal. Anisocoria to a mild degree (generally 0.3 to 0.5 mm) can be found in about 20% of people. This form is termed "simple anisocoria." When pathological, it may be seen in a variety of nervous system pathologies such as Wernicke-Korsakoff syndrome.
In the absence of any deformities of the iris or eyeball proper, anisocoria is usually the result of a defect in efferent nervous pathways controlling the pupil traveling in the oculomotor nerve (parasympathetic fibers) or the sympathetic pathways. Physical lesions and drugs causing anisocoria will do so via disruption of these pathways.
Some examples of drugs which may affect the pupils include pilocarpine, cocaine, tropicamide and scopolamine.
Additionally, dilation of the pupil is termed mydriasis and constriction of the pupil is termed miosis.
Complete Differential Diagnosis of Anisocoria
- Adie's Syndrome
- Alcohol intoxication
- Aniridia
- Argyll-Robertson Pupil
- Arsenic poisoning
- Botulism
- Brain tumor
- Cavernous sinus thrombosis
- Cerebral aneurysm
- Congenital
- Degenerative neurologic disorders
- Diabetes Mellitus
- Diphtheria
- Drugs
- Encephalitis
- Herpes Zoster
- Horner's Syndrome
- Injury to the iris
- Internal carotid artery aneurysm
- Intracranial hemorrhage
- Iridocyclitis
- Ischemia
- Keratitis
- Lead poisoning
- Meningitis
- Multiple Sclerosis
- Narrow Angle Glaucoma
- Neoplastic
- Neurofibromatosis
- Ocular prosthesis
- Retinal disease
- Syphilis
- Syringomyelia
- Tabes Dorsalis
- Trauma
- Tuberculosis
Interpretation
Clinically, it is important to establish which of the two pupils is behaving abnormally.
- If the smaller of the two pupils is the abnormal one, dimming the ambient light will not cause it to dilate, in which case a defect in sympathetic fibers is suspected, as seen in Horner's syndrome.
- Alternatively, if the abnormal pupil is the larger one, it will fail to contract in response to light, raising suspicion for a parasympathetic nerve defect, possibly an oculomotor nerve palsy.
A relative afferent pupillary defect or RAPD also known as a Marcus Gunn pupil does not cause anisocoria.
When anisocoria occurs and the examiner is unsure whether the abnormal pupil is the constricted or dilated one, if a one-sided ptosis is present then the abnormally sized pupil can be presumed to be the one on the side of the ptosis.
See also
References
Additional Resources
- "Anisocoria." Stedman's Medical Dictionary, 27th ed. (2000). ISBN 0-683-40007-X
- Victor, Maurice and Allan H. Ropper. Adams and Victor's Principles of Neurology, 7th ed. (2001). ISBN 0-07-067497-3
External links
WikiDoc Research Resources for Anisocoria | |
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| Articles on Anisocoria | Most recent articles on Anisocoria • Most cited articles on Anisocoria • Review articles on Anisocoria • Articles on Anisocoria in N Eng J Med, Lancet, BMJ |
| Media (Slides, Video, Images, MP3) on Anisocoria | Powerpoint slides on Anisocoria • Images of Anisocoria • Photos of Anisocoria • Podcasts & MP3s on Anisocoria • Videos on Anisocoria |
| Evidence Based Medicine Regarding Anisocoria | Cochrane Collaboration on Anisocoria • Bandolier on Anisocoria • TRIP on Anisocoria |
| Cost Effectiveness of Anisocoria | Cost Effectiveness of Anisocoria |
| Clinical Trials Involving Anisocoria | Ongoing Trials on Anisocoria at Clinical Trials.gov • Trial results on Anisocoria • Clinical Trials on Anisocoria at Google |
| Guidelines / Policies / Government Resources (FDA/CDC) Regarding Anisocoria | US National Guidelines Clearinghouse on Anisocoria • NICE Guidance on Anisocoria • NHS PRODIGY Guidance • FDA on Anisocoria • CDC on Anisocoria |
| Textbook Information on Anisocoria | Books and Textbook Information on Anisocoria |
| Pharmacology Resources on Anisocoria | Dosing of Anisocoria • Drug interactions with Anisocoria • Side effects of Anisocoria • Allergic reactions to Anisocoria • Overdose information on Anisocoria • Carcinogenicity information on Anisocoria • Anisocoria in pregnancy • Pharmacokinetics of Anisocoria • |
| Genetics, Pharmacogenomics, and Proteinomics of Anisocoria | Genetics of Anisocoria • Pharmacogenomics of Anisocoria • Proteomics of Anisocoria |
| Newstories on Anisocoria | Anisocoria in the news • Be alerted to news on Anisocoria • News trends on Anisocoria |
| Commentary on Anisocoria | Blogs on Anisocoria |
| Patient Resources on Anisocoria | Patient resources on Anisocoria • Discussion groups on Anisocoria • Patient Handouts on Anisocoria • Directions to Hospitals Treating Anisocoria • Risk calculators and risk factors for Anisocoria |
| Healthcare Provider Resources on Anisocoria | Symptoms of Anisocoria • Causes & Risk Factors for Anisocoria • Diagnostic studies for Anisocoria • Treatment of Anisocoria |
| Continuing Medical Education (CME) Programs on Anisocoria | CME Programs on Anisocoria |
| International Resources on Anisocoria | Anisocoria en Espanol • Anisocoria en Francais |
| Business Resources on Anisocoria | Anisocoria in the Marketplace • Patents on Anisocoria |
| Informatics Resources on Anisocoria | List of terms related to Anisocoria |
de:Anisokoriefr:Anisocorie it:Anisocoria nl:Anisocoriesr:Анизокорија
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
