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In this video, we'll discuss the common causes of anisocoria (unequal pupil sizes) and how to determine the cause.
Welcome to an insightful lecture on the evaluation of anisocoria, a condition characterized by unequal pupil sizes. we begin by defining anisocoria as the presence of unequal pupils, with one larger than the other. We emphasize that anisocoria can be either physiological or pathological, depending on the magnitude of the size difference.
In physiological anisocoria, the difference in pupil size is typically 1 mm or less, and both pupils react normally to light and dark conditions. However, in pathological cases, the difference exceeds 1 mm and may indicate underlying issues requiring evaluation.
in this video we stress the importance of taking a thorough patient history, including onset, associated symptoms, ocular trauma, and medication use. We have highlighted specific conditions, such as congenital Horner syndrome, third nerve palsy, and uveitis, which may cause pathological anisocoria.
During the ocular examination, Dr. Amrit demonstrates how to compare pupil sizes in both light and dark environments. She explains that if anisocoria is greater in light, the abnormal pupil is the larger one, indicating pathology such as traumatic iris sphincter damage, Adie's pupil, or third nerve palsy. Conversely, if anisocoria is greater in darkness, the abnormal pupil is the smaller one, suggesting conditions like pharmacological mydriasis, iritis, Horner syndrome, or argyll Robertson pupil.
Dr. Amrit discusses pharmacological testing, including the use of cocaine and pilocarpine, to differentiate between conditions like Horner syndrome and pharmacological mydriasis. She also emphasizes the importance of slit lamp examination to detect signs of iris sphincter damage.
In conclusion, this video provides a comprehensive understanding of anisocoria evaluation, highlighting key examination techniques, diagnostic tests, and differential diagnoses.
#ophthalmology #insight ophthalmology
#anisocoria
#neuroophthalmology