Fixed Pupils: Causes & Reasons

Possible Causes for Fixed Pupils

Hyperventilation or Cheyne-Stokes Absent (eyes fixed) Decerebrate posturing, or nothing Lower pons and medilla Both pupils fixed and unreactive Apnoea Absent (eyes fixed) [derangedphysiology.com]

At this point, the left pupil became fixed. An ICP bolt was inserted (opening pressure 50 mm Hg; Figure ). [stroke.ahajournals.org]

- ipsilateral fixed and dil… - bilateral pinpoint pupils... - bilateral Babinski's... - *bila… - compress ACA... --> contralateral lower extremity motor/sensory… brain herniation [quizlet.com]

Botulism

Therefore, the classical diagnostic pentad of botulism (dry mouth, nausea, vomiting, dysphagia, diplopia, fixed dilated pupils) may be of limited sensitivity in single cases [ncbi.nlm.nih.gov]

Less than 50% of patients have dilated or fixed pupils. Neurological deficits are symmetrical, and heart rate is normal. [web.archive.org]

pupils Extremely dry mouth unrelieved by drinking fluids Generally, botulism progresses as follows: Preceding or following the onset of paralysis are nonspecific findings [emedicine.medscape.com]

Brain Death

A 28-year-old man was admitted following a road traffic accident with a Glasgow Coma Score (GCS) of 3/15 and fixed pupils. [ncbi.nlm.nih.gov]

On day three his Glasgow Coma Scale score was 3/15, with fixed dilated pupils. [ncbi.nlm.nih.gov]

Reflexes include pupillary response (fixed pupils), oculocephalic reflex, corneal reflex, no response to the caloric reflex test, and no spontaneous respirations. [en.wikipedia.org]

Berry Aneurysm

Immediately after reduction of the cerebrospinal fluid volume, arterial hypertension was noticed—the right pupil was mydriatic and fixed. [link.springer.com]

Ventricular Fibrillation

Ventricular Fibrillation (VF or V-fib) {{{locatieafbeelding}}} Atrial rate 60-100 bpm Ventricular rate 400-600 bpm Regularity irregular Origin ventricles P-wave AV-dissociation Effect of adenosine none Example ECG: {{{example}}} Example ECG2: {{{example2}}} Ventricular fibrillation (VF or V-fib) is chaotic[…] [en.ecgpedia.org]

Multisystemic Smooth Muscle Dysfunction Syndrome

Home Catalog Congenital fixed dilated pupils due to ACTA2-mu... article Congenital fixed dilated pupils due to ACTA2-multisystemic smooth muscle dysfunction syndrome Françoise [lib.ugent.be]

Congenital Fixed Dilated Pupils Due to ACTA22 Multisystemic Smooth Muscle Dysfunction Syndrome Page Metadata Title Congenital Fixed Dilated Pupils Due to ACTA22 Multisystemic [collections.lib.utah.edu]

Congenital fixed dilated pupils (congenital mydriasis) is characterized by hypoplasia or aplasia of the iris muscles, with absence of iris between the collarette and pupillary [ncbi.nlm.nih.gov]

Congenital Non-Progressive Ataxia

The combination of muscular hypotonia and fixed dilated pupils in infancy is suspicious of Gillespie syndrome. [ncbi.nlm.nih.gov]

The typical presentation is based on fixed dilated pupils in a hypotonic child. Iris abnormalities distinguish GS from other forms of aniridia. [ncbi.nlm.nih.gov]

The typical presentation is the discovery of fixed dilated pupils in a hypotonic infant. The iris abnormality is specific and seems pathognomonic of Gillespie syndrome. [ncbi.nlm.nih.gov]

Acute Glaucoma

Normal Small Fixed, Irreg Dilated, Fixed, Oval Iris Normal Muddy Grey - Green Tension Normal Normal High Red Tarsal Central Central Px Toilet, AB, Shades Atropine, Heat, [emed.ie]

The diagnosis of acute glaucoma in a patient who presents with sudden onset of a painful, red eye with reduced visual acuity, a hazy cornea, and a fixed, semi-dilated pupil [ncbi.nlm.nih.gov]

The eye in a far advanced case of angle closure glaucoma appears red with a steamy (clouded) cornea and a fixed (nonreactive) dilated pupil. [medicinenet.com]

Anisocoria

From that day, Bowie's left pupil remained in a fixed open position. [dailymail.co.uk]

From that day, Bowie’s left pupil remained in a fixed open position. [theconversation.com]

Acute presentation often includes pain, corneal edema, raised intraocular pressure, and a light-fixed midposition pupil. [emedicine.medscape.com]

Tonic Pupil

The dust contains stramonium, a mydriatic. fixed pupil A pupil that does not react to stimuli. [medical-dictionary.thefreedictionary.com]

Left relative afferent pupillary defect in the presence of a right dilated fixed pupil Bilateral light near dissocations Vermiform movement of an Adie's pupil [mrcophth.com]

[…] trauma can result in a fixed and dilated pupil. [reviewofoptometry.com]

Nothnagel Syndrome

Identifier 166-26 Title Fascicular Third Nerve Palsy Ocular Movements Ptosis; Third Nerve Palsy; Fixed Dilated Pupil; Subnuclear Creator Shirley H. [collections.lib.utah.edu]

pupils, hydrocephalus retraction nystagmus Dorsal Midbrain MillardGubler and Base of Raymond- Pons Foville Ocular palsies, paralysis of Tumor gaze, cerebellar ataxia VII [docshare.tips]

[…] wide pupil pointed down and out; probable diplopia It is very similar to Benedikt's syndrome. [en.wikipedia.org]

Benedict Syndrome

pupils Pinealoma and other lesions of dorsal midbrain, hydrocephalus Millard-Gubler syndrome and Raymond Foville Syndrome Site Millard-Gubler syndrome and Raymond Foville [quizlet.com]

pupils, hydrocephalus retraction nystagmus Dorsal Midbrain MillardGubler and Base of Raymond- Pons Foville Ocular palsies, paralysis of Tumor gaze, cerebellar ataxia VII [docshare.tips]

In more than 95% of aneurysmal palsies, the pupil reacts sluggishly to light or is fixed and dilated, but, in 73%, of ischemic palsies, the pupil is spared. [emedicine.medscape.com]

Food-Borne Botulism

pupils, or dry mouth and throat--and 20 (49%) required respiratory assistance. [ncbi.nlm.nih.gov]

Difficulty in breathing, moderate to severe ptosis, and dilated and fixed pupils were associated with respiratory failure. [ncbi.nlm.nih.gov]

Pupils fixed in mid position or dilated. Fever is unusual, as is loss of sensation. Differential diagnosis Descending form of acute inflammatory polyneuropathy. [patient.info]

Oculomotor Nerve Paralysis

[…] the first to be affected by compression resulting in a fixed and dilated pupil. [oxfordmedicaleducation.com]

[…] travelling to the pupil; thus the pupils are midposition (medium size) and fixed (no light reflex in either pupil). 4. [kobiljak.msu.edu]

Tentorial herniation is not a plausible explanation for an isolated, fixed, and dilated pupil in the absence of an altered mental status or other neurologic abnormalities. [aao.org]

Acute Angle Closure Glaucoma

Slit-lamp examination showed bilateral conjunctival hyperemia, slight diffuse corneal edema, shallow anterior chamber and fixed and dilated pupil in both eyes. [ncbi.nlm.nih.gov]

The eye in a far advanced case of angle closure glaucoma appears red with a steamy (clouded) cornea and a fixed (nonreactive) dilated pupil. [medicinenet.com]

On exam, she has scleral injection, a hazy cornea, and mid-dilated, fixed pupil. The globe itself feels rock hard on palpation. [emdocs.net]

Myopia-Ophthalmoplegia Syndrome

Fixed, dilated pupil, iris atrophy and secondary glaucoma. Am J Ophthalmol. 1963;56:257- 65. [ Links ] [bjan-sba.org]

Fixed, dilated pupil after phakic intraocular lens implantation. J Cataract Refract Surg. 2006;32:174- 6. [ Links ]. Urrets Zavalia Jr A. [bjan-sba.org]

Hereditary Sensory and Autonomic Neuropathy Type 4

Clinical manifestations are present at birth and include diminished lacrimation, defective thermoregulation, orthostatic hypotension (HYPOTENSION, ORTHOSTATIC), fixed pupils [termsciences.fr]

Papillary Conjunctivitis

With acute angle-closure glaucoma, the pupil is generally fixed in mid-position, oval, and responds sluggishly to light, if at all. [en.wikipedia.org]

Generally, conjunctivitis does not affect the pupils. [en.wikipedia.org]

Gillespie Syndrome

The iris may be relatively intact but immobile leading to the description in some patients of "dilated and fixed pupils", or congenital mydriasis. [disorders.eyes.arizona.edu]

[…] dilated pupils in infancy is suspicious of Gillespie syndrome.[5] Early onset partial aniridia, cerebellar ataxia, and mental retardation are hallmark of syndrome.[6] The [en.wikipedia.org]

A thin rim of iridal tissue (arrow) results in a fixed and dilated appearance of the pupil, consistent with iris hypoplasia (A). [scielo.br]

Orbital Periostitis

[…] dilated pupil: due to loss of parasympathetic supply to the pupil by the oculomotor nerve Lacrimal hyposecretion and eyelid or forehead anaesthesia: due to damage to branches [eyewiki.aao.org]

[…] superioris and loss of sympathetic input (third order postganglionic) to Muller’s muscle Proptosis: due to decreased tension in the extraocular muscles with loss of innervation Fixed [eyewiki.aao.org]

Blepharoconjunctivitis

With acute angle-closure glaucoma, the pupil is generally fixed in mid-position, oval, and responds sluggishly to light, if at all. [en.wikipedia.org]

Generally, conjunctivitis does not affect the pupils. [en.wikipedia.org]

Parinaud Syndrome

There may be changes in pupillary responses (fixed pupils in response to light but which constrict in accommodation) and often there is eyelid retraction and a lag in elevating [lksom.temple.edu]

The syndrome is characterized by dilated fixed pupils to light, loss of upward gaze, defective convergence, skew deviation, light near dissociation (reaction to accommodation [umedico.com]

pupils Pinealoma and other lesions of dorsal midbrain, hydrocephalus Millard-Gubler syndrome and Raymond Foville Syndrome Site Millard-Gubler syndrome and Raymond Foville [quizlet.com]

Angle Closure Glaucoma

[…] mid-dilated pupil (4-6 mm) that reacts poorly to direct illumination, a hazy cornea that may be edematous, hyperemia of the conjunctiva and a shallow anterior chamber. [symptoma.com]

On exam, she has scleral injection, a hazy cornea, and mid-dilated, fixed pupil. The globe itself feels rock hard on palpation. [emdocs.net]

The eye in a far advanced case of angle closure glaucoma appears red with a steamy (clouded) cornea and a fixed (nonreactive) dilated pupil. [medicinenet.com]

Intracranial Subdural Hematoma

One-year outcome following craniotomy for traumatic hematoma in patients with fixed dilated pupils. J Neurosurg. 1995 Jun. 82(6):961-5. [QxMD MEDLINE Link]. [emedicine.medscape.com]

These authors claimed a 25% functional recovery rate (defined by the Glasgow Outcome Scale) in patients presenting with fixed, dilated pupils. [21] Acute subdural hematomas [emedicine.medscape.com]

The outcome status of the patients with bilateral nonreactive pupils who survived was not noted. [19] Wilberger et al also found an 88% mortality associated with fixed, dilated [emedicine.medscape.com]

Orbital Apex Syndrome

The orbital apex syndrome is a very rare complication of fractures of the facial skeleton, as well as other conditions and is characterized by blindness, fixed dilated pupils [ncbi.nlm.nih.gov]

On examination, she had right-sided axial proptosis (Figure-1 and 2), complete ophthalmoplegia with dilated and fixed pupil. [jpma.org.pk]

According to certain reports, blurred vision arising from reduced visual acuity and a fixed dilated pupil is the most frequent symptom in OAS. [symptoma.com]

Cavernous Sinus Aneurysm

Ocular examination revealed features of left orbital cellulitis, the globe was tender and fixed. Left pupil was reacting sluggishly. [ijo.in]

pupil (CN III compression) ophthalmic sensory loss compression of V 1 maxillary sensory loss compression of V 2 Horner syndrome disruption of ocular sympathetics Please rate [medbullets.com]

A complete lesion of the cavernous sinus disrupts CN III, IV, and VI, causing total ophthalmoplegia, usually accompanied by a fixed, dilated pupil. [fmritools.com]

McPherson-Robertson-Cammarano Syndrome

Chemical compound and disease context of Pupil Disorders The pupillometer also exhibited reasonable accuracy in fixed pupils dilated with tropicamide [10]. [wikigenes.org]

The dust contains stramonium, a mydriatic. fixed pupil A pupil that does not react to stimuli. [medical-dictionary.thefreedictionary.com]

[…] are fixed, dilated and tonic, direct and consensual pupil reactions are weak and absent pupils are constricted and fixed, occurs with eye drops for glaucoma, iritis, brain [quizlet.com]

Middle Ear Cholesteatoma

This report emphasises the importance of accurate history taking when evaluating fixed dilated pupil. [emj.bmj.com]

Fixed dilated pupil: dilated, unresponsive pupil, e.g. due to closed-angle glaucoma Hutchinson pupil: Pupillary abnormalities that lead to a fixed dilated pupil in 3 stages [amboss.com]

The fixed dilated pupil: sudden iridoplegia or mydriatic drops? A simple diagnostic test. Arch Ophthalmol 1971; 86: 21–27. 2 Jacobson DM. [nature.com]

Spastic Ataxia with Congenital Miosis

Argyll Robertson pupil one that is miotic and responds to accommodation effort, but not to light. fixed pupil a pupil that does not react either to light or on convergence [medical-dictionary.thefreedictionary.com]

Associated signs of fixed pupils, horizontal gaze problems, and skew deviation are more common with hemorrhages than infarcts. [neuroophthalmology.ca]

The pupils are about 2 mm in size and have been described as 'fixed' since they do not dilate in low light or constrict in bright light. [disorders.eyes.arizona.edu]

Spleen Disease

This report emphasises the importance of accurate history taking when evaluating fixed dilated pupil. [emj.bmj.com]

Fixed dilated pupil: dilated, unresponsive pupil, e.g. due to closed-angle glaucoma Hutchinson pupil: Pupillary abnormalities that lead to a fixed dilated pupil in 3 stages [amboss.com]

The fixed dilated pupil: sudden iridoplegia or mydriatic drops? A simple diagnostic test. Arch Ophthalmol 1971; 86: 21–27. 2 Jacobson DM. [nature.com]