![]() Physiologic anisocoria is usually less than 1.0 mm and can change from day to day. Swinging flash-light test (examiner facing patient). This is found in optic neuropathy, retinopathy, Adie’ tonic pupil, Argyll Robertson pupil, Parinaud’ dorsal midbrain syndrome, aberrant regeneration of the third nerve, and diabetes.įigure 19-1. ![]() In light-near dissociation (LND) of pupils, there is better pupillary response to near stimuli than to light stimuli.Third-nerve palsy-Dilated pupil accompanied by ptosis and extraocular muscle palsies.Anhidrosis will be present if the lesion involves the sympathetic pathway proximal to the bifurcation of the common carotid artery. Horner’ syndrome-Miotic pupil accompanied by ptosis and possibly anhidrosis.Pharmacologic pupil-Either miotic or dilated pupil that does not respond to any pharmacologic testing.Argyll Robertson pupil-The miotic pupils are irregular and do not respond to light with poor dilation in the dark yet good near response. ![]()
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