Pupillary dilation: Difference between revisions
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{{Infobox_Disease | | {{Infobox_Disease | | ||
Name = {{PAGENAME}} | | Name = {{PAGENAME}} | | ||
Image = Pupillary dilation.jpg | | Image = Pupillary dilation.jpg | | ||
Caption = Pupillary dilation | | Caption = Pupillary dilation | | ||
}} | }} | ||
{{Search infobox}} | {{Search infobox}} | ||
{{CMG}} | {{CMG}} | ||
==Overview== | ==Overview== | ||
The action of the iris dilator muscle is controlled by the sympathetic system, which in turn controls '''pupillary dilation'''. The superior cervical ganglion is the source of the third order neuron and follows the internal cartoid artery brances.<br> Sympathetic activity that goes unopposed can cause unequal pupil size. | The action of the iris dilator muscle is controlled by the sympathetic system, which in turn controls '''pupillary dilation'''. The superior cervical ganglion is the source of the third order neuron and follows the internal cartoid artery brances.<br> Sympathetic activity that goes unopposed can cause unequal pupil size. | ||
== | ==Causes== | ||
===Causes in Alphabetical Order<ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref><ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>=== | |||
*[[Acute Closed Angle glaucoma]] | *[[Acute Closed Angle glaucoma]] | ||
| Line 46: | Line 34: | ||
:*Ophthalmologic | :*Ophthalmologic | ||
:*Otolaryngologic | :*Otolaryngologic | ||
=== Physical Examination === | === Physical Examination === | ||
=== Eyes === | === Eyes === | ||
*Pupil size (light & dark) | *Pupil size (light & dark) | ||
| Line 54: | Line 40: | ||
*Lid position | *Lid position | ||
=== MRI | ===MRI=== | ||
*MRI to check for [[third cranial nerve palsy]] | *MRI to check for [[third cranial nerve palsy]] | ||
== Treatment == | ==Treatment== | ||
=== | ===Medical Therapy=== | ||
*[[Adie's pupil]] - Pilcarpine .125% BID-QID | *[[Adie's pupil]] - Pilcarpine .125% BID-QID | ||
*Migraines - pain meds, antidepressants, anticonvulsants, beta blockers, calcium channel blockers | *Migraines - pain meds, antidepressants, anticonvulsants, beta blockers, calcium channel blockers | ||
== Primary Prevention == | ===Primary Prevention=== | ||
*Remove causative medication | *Remove causative medication | ||
*Sunglasses to decrease light sensitivity | *Sunglasses to decrease light sensitivity | ||
==References== | ==References== | ||
{{ | {{reflist|2}} | ||
{{WikiDoc Help Menu}} | {{WikiDoc Help Menu}} | ||
Revision as of 20:26, 20 February 2013
| Pupillary dilation | |
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| Pupillary dilation |
Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The action of the iris dilator muscle is controlled by the sympathetic system, which in turn controls pupillary dilation. The superior cervical ganglion is the source of the third order neuron and follows the internal cartoid artery brances.
Sympathetic activity that goes unopposed can cause unequal pupil size.
Causes
Causes in Alphabetical Order[1][2]
- Acute Closed Angle glaucoma
- Adie's tonic pupil
- Adregenic agents
- Benign episodic mydriasis
- Coma
- Congenital mydriasis
- Drug withdrawal
- Hallucinogens
- Seizures
- Serotonin syndrome
- Systemic anticholinergics
- Third nerve palsy
- Trauma
Diagnosis
History and Symptoms
- Complete history with special attention to:
- neurologic
- Ophthalmologic
- Otolaryngologic
Physical Examination
Eyes
- Pupil size (light & dark)
- Pupil response to light and convergence
- Lid position
MRI
- MRI to check for third cranial nerve palsy
Treatment
Medical Therapy
- Adie's pupil - Pilcarpine .125% BID-QID
- Migraines - pain meds, antidepressants, anticonvulsants, beta blockers, calcium channel blockers
Primary Prevention
- Remove causative medication
- Sunglasses to decrease light sensitivity