II. Pathophysiology

  1. Images
    1. EyePupillaryReactionNeuroPath.png
    2. EyePupillaryReaction.png

III. Definition

  1. Inequality between pupil diameters

IV. Differential Diagnosis: General

  1. Congenital (normal variant in 20% of population)
  2. Tabes Dorsalis
  3. Trigeminal Neuralgia
  4. Carotid aneurysm
  5. Aortic aneurysm
  6. Unilateral Intracranial Mass
  7. Glaucoma
  8. Adie's Pupils
  9. Amblyopia
  10. Horner Syndrome
  11. Third nerve palsy (or parasympathetic abnormality)

V. Findings: Miosis (Pupil Constriction) of one, but not the other

  1. Iritis
  2. Cervical sympathetic paralysis
  3. Miotic drug (e.g. Pilocarpine)

VI. Findings: Mydriasis (pupil dilatation) of one, but not the other

  1. Mydriatic drug (e.g. Atropine)
  2. Cranial Nerve III paralysis
  3. Acute Glaucoma
  4. Brainstem Herniation (non-reactive dilated pupil in comatose patient)

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