How do you evaluate anisocoria?
Anisocoria greater in the dark indicates the small pupil to be abnormal due to poor pupillary dilation. A small amount of anisocoria that is equal in both light and dark conditions most likely represents physiologic anisocoria.
Is anisocoria a diagnosis?
Anisocoria is a condition characterized by unequal pupil sizes. It is relatively common, and causes vary from benign physiologic anisocoria to potentially life-threatening emergencies. Thus, thorough clinical evaluation is important for the appropriate diagnosis and management of the underlying cause.
Can physiologic anisocoria come and go?
While small differences in pupil size are normal and can even come and go (physiologic anisocoria), constant and significant differences in pupil sizes may be a sign of damage to the nerves that control the pupils or to the brain.
What is a Marcus Gunn pupil?
Marcus Gunn pupil (MGP) is the term given to an abnormal pupil showing aberrant pupillary response in certain ocular disorders. In literature, the term is often used synonymously with Marcus Gunn phenomenon or relative afferent pupillary defect (RAPD). [1] After exposure to bright light, a normal pupil constricts.
What is Hutchinson’s pupil?
Hutchinson’s pupil is a clinical sign in which the pupil on the side of an intracranial mass lesion is dilated and unreactive to light, due to compression of the oculomotor nerve on that side. The sign is named after Sir Jonathan Hutchinson.
What is anisocoria and why does it matter?
Anisocoria is a term which refers to the pupils being different sizes. In many people, the size of the pupils is the same in each eye, and both pupils will become smaller or bigger to let light in at the same time. The presence of anisocoria can be normal (physiologic), or it can be a sign of an underlying medical condition.
What is the normal range of anisocoria?
Physiological Anisocoria Physiologic anisocoria is usually defined as a pupillary inequality of 0.4 mm, seldom greater than 0.8 mm, not due to a secondary cause. If the anisocoria is physiologic, the difference in pupil sizes should remain equal in dim and bright lights.
What is anisocoria (uneven pupils)?
Anisocoria is when your eye’s pupils are not the same size. The pupil allows light to enter the eye so that you can see. Anyone can have pupils that differ in size with no problems. In fact, one out of five people have pupils that are normally different sizes. Sometimes, though, having uneven pupil size can be a symptom of a serious eye problem.
Why is thorough clinical evaluation important for the diagnosis of anisocoria?
Thus, thorough clinical evaluation is important for the appropriate diagnosis and management of the underlying cause. Generally, anisocoria is caused by impaired dilation (a sympathetic response) or impaired constriction (a parasympathetic response) of pupils.