Pupillary Abnormality: Causes & Reasons

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Possible Causes for Pupillary Abnormality

Tonic Pupil

Abnormal pupillary shape The human pupil should be round. [patient.info]

This pupillary abnormality may result from ischaemia of the ciliary ganglia. [ncbi.nlm.nih.gov]

Pupillary abnormalities [ 1 ] Pupillary disorders may involve the afferent pathways (RAPD) or the efferent pathways. [patient.info]

Epidural Hematoma

And patients with abnormal pupillary amounted to 24 people (40%). [biomedpharmajournal.org]

Factors that may influence outcome are as follows: Patient age Time lapsed between injury and treatment Immediate coma or lucid interval Presence of pupillary abnormalities [ncbi.nlm.nih.gov]

The risk factors identified, age, GCS, pupillary abnormalities, lucid interval, volume and location of the EDH, midline shift and other focal lesions. [biomedpharmajournal.org]

Posterior Synechiae

Abnormal pupillary shape The human pupil should be round. [patient.info]

abnormalities H21.561 Pupillary abnormality, right eye H21.562 Pupillary abnormality, left eye H21.563 Pupillary abnormality, bilateral H21.569 Pupillary abnormality, unspecified [icd10data.com]

abnormalities Inclusion term(s): Deformed pupil Ectopic pupil Rupture of sphincter, pupil H21.561 Pupillary abnormality, right eye H21.562 Pupillary abnormality, left eye [icd10coded.com]

Anisocoria

Diagnostic approach to pupillary abnormalities. Continuum (Minneap Minn) 2014;20:1008-22. 4. Cahill JA, Ross J. [mijn.bsl.nl]

[…] a pupillary abnormality. [aapos.org]

Finally, an abnormality of the third cranial nerve (a nerve that comes from the brain to the eye socket and controls eyelid position, eye movement, and pupil size) can cause [aapos.org]

Oculomotor Nerve Paralysis

Therefore, while almost all forms ('medical third' and 'surgical third') cause ptosis and impaired movement of the eye, pupillary abnormalities are more commonly associated [en.wikipedia.org]

For more details about oculomotor nerve lesions and drugs affecting pupillary size, see the learning card pupillary abnormalities. [amboss.com]

For more information, refer to page 1011 of the CONTINUUM article “Diagnostic Approach to Pupillary Abnormalities.” [neuro-ophthalmology.stanford.edu]

Anterior Synechiae

abnormalities Inclusion term(s): Deformed pupil Ectopic pupil Rupture of sphincter, pupil H21.561 Pupillary abnormality, right eye H21.562 Pupillary abnormality, left eye [icd10coded.com]

[…] membranes 364.75 - Pupillary abnormalities 364.76 - Iridodialysis 364.77 - Recession of chamber angle of eye [emedcodes.com]

[…] membranes 364.75 Pupillary abnormalities 364.76 Iridodialysis 364.77 Recession of chamber angle of eye 364.81 Floppy iris syndrome 364.82 Plateau iris syndrome 364.89 Other [healthprovidersdata.com]

Horner's Syndrome

Pupillary abnormalities ; Atlas of Ophthalmology Crippa SV, Borruat FX, Kawasaki A ; Pupillary dilation lag is intermittently present in patients with a stable oculosympathetic [patient.info]

Pupillary abnormalities. Also consider unilateral use of miotic drugs. Investigations Investigations will be guided by suspected aetiology. [patient.info]

Optic Neuropathy

There were no pupillary abnormalities noted. Ophthalmoscopy revealed variable, and often times subtle, temporal pallor of the optic nerve. [iovs.arvojournals.org]

Common Pupillary Abnormalities Finding Explanation Asymmetry of 1–2 mm between pupils, preserved light responses, and no symptoms Normal variant (physiologic anisocoria) Asymmetry [merckmanuals.com]

For instance, red colour may be viewed as a lighter shade, or another colour similar to red in a patient shows signs of optical neuropathy. 6 Ø Abnormal pupillary response [biotecharticles.com]

Tabes Dorsalis

Pupillary abnormalities are present in almost all the cases. Pupils on two sides are unequal. Accomodation reflex is retained while light reflex is lost. [healthdrip.com]

[…] after infection Ischemia along MCA territory Meningeal inflammation 10 years after infection Impairment of higher cortical functions Dementia Frontotemporal encephalitis pupillary [quizlet.com]

The mydriatic reaction to atropine is rather poor, and the pupil does not dilate with painful skin stimuli. [13] It must be realized, however, that pupillary abnormalities [ijstd.org]

Intrapontine Hemorrhage

abnormalities. [aic.cuhk.edu.hk]

[…] pontine haemorrhages that would previously not be detected A case series of 26 patients suggests that prognosis is related to size of the haematoma level of consciousness pupillary [aic.cuhk.edu.hk]

Subdural Hematoma

Also several studies have shown increased mortality in patients with the presence of pupillary abnormalities, which was seen acutely in our patient. [hindawi.com]

Most patients (65-80%) present with a severely depressed conscious state, and pupillary abnormalities are seen in ~40% (range 30-50%) of cases 5. [radiopaedia.org]

Successful use of the new high-dose mannitol treatment in patients with Glascow Coma Scale Scores of 3 and bilateral abnormal pupillary widening: a randomized trial. [ebmconsult.com]

Wernicke Encephalopathy

Less frequently noted manifestations are: pupillary abnormalities such as sluggishly reactive pupils, ptosis, scotomata, and anisocoria. [emedicine.medscape.com]

abnormalities such as sluggishly reactive pupils, ptosis, scotomata, and anisocoria OTHER SYMPTOMS Vestibular dysfunction Hypotension. [rnpedia.com]

Double vision Eyelid drooping bilateral lateral rectus palsies conjugate gaze palsies reflecting cranial nerve involvement of the oculomotor, abducens, and vestibular nuclei pupillary [rnpedia.com]

Encephalitis

The patient showed pupillary abnormalities suggestive of a diagnosis of neurosyphilis, and the diagnosis was supported by the results of a serum Treponema pallidum hemagglutination [jstage.jst.go.jp]

Intracerebral Hematoma

abnormalities (present in 30-50%) Papilledema Asymmetric reflexes Babinski sign Aphasia or dysphasia Gait abnormalities Neck stiffness etc. [faculty.washington.edu]

TICH group with other traumatic intracranial lesions showed worse initial level of consciousness, more likely to have abnormal pupillary reflex, higher incidence of delayed [jkns.or.kr]

Be sure to evaluate the patient’s pupillary light reflexes. [medical-dictionary.thefreedictionary.com]

Traumatic Brain Injury

Successful use of the new high-dose mannitol treatment in patients with Glasgow coma scores of 3 and bilateral abnormal pupillary widening: a randomized trial. [ncbi.nlm.nih.gov]

Pupillary and eyelid abnormalities, Janet C. Rucker, M.D. 18. Dizziness, Vertigo, & Hearing loss, Robert W. Baloh, MD and Kevin Kerber, MD 19. [worldcat.org]

In the United States, all severe head injury patients with abnormal pupillary signs routinely receive 100 mL of mannitol 20% upon arrival in the emergency department. [emedicine.com]

Optic Neuritis

When optic neuritis is present, the pupil always appears abnormal (afferent pupillary defect). [allaboutvision.com]

[…] light reaction test (to check for abnormal function of the pupil), and blood tests. [blinkcharlotte.com]

It has been shown to be poor at detecting postchiasmal lesions. 31, 34, 35, 36, 37, 38, 39 Pupillary responses and optic disc abnormalities are the principal objective signs [doi.org]

Syphilis

On examination there was a sluggish right pupillary response but no other abnormal findings. Serum and CSF syphilis serology were both strongly positive. [ncbi.nlm.nih.gov]

Tremors of the mouth, tongue, outstretched hands, and whole body may occur; other signs include pupillary abnormalities, dysarthria, hyperreflexia, and, in some patients, [msdmanuals.com]

Neurosyphilis

Physical examination revealed no cranial nerve palsies or pupillary abnormalities. [cmaj.ca]

Late neurologic symptoms include pupillary abnormalities, hypotonia, seizures, and involvement in cranial nerves II, III, VI, VII and VIII (Simon, 1985). [priory.com]

abnormalities, flattening of the facial muscles, and increased deep tendon reflexes.25 The Babinski sign and the Argyll Robertson pupil occurred in late stages.25 Early motor [healio.com]

Cerebral Hemorrhage

pupillary widening: a randomized trial. [doi.org]

Google Scholar Cruz J, Minoja G, Okuchi K: Major clinical and physiological benefits of early high doses of mannitol for intraparenchymal temporal lobe hemorrhages with abnormal [doi.org]

Brain Death

Other situations possibly requiring confirmatory testing include severe facial trauma where determination of brainstem reflexes will be difficult, pre-existing pupillary abnormalities [en.wikipedia.org]

Other variables that are correlated with a poor outcome include an advanced age, pupillary abnormalities, and a low score on a test of motor responses 47. [doi.org]

Abnormal pupillary activity in a brainstem-dead patient. Br J Anaesth 2001 ; 86 : 717 –720. ↵ de Freitas GR, Andre C. Absence of the Babinski sign in brain death. [neurology.org]

Uveitis

[…] membranes convert 364.74 to ICD-10-CM 364.75 Pupillary abnormalities convert 364.75 to ICD-10-CM 364.76 Iridodialysis convert 364.76 to ICD-10-CM 364.77 Recession of chamber [icd9data.com]

[…] convert 364.71 to ICD-10-CM 364.72 Anterior synechiae of iris convert 364.72 to ICD-10-CM 364.73 Goniosynechiae convert 364.73 to ICD-10-CM 364.74 Adhesions and disruptions of pupillary [icd9data.com]

Glaucoma

[…] than with relative pupillary block ( Ritch 2003 ). [doi.org]

19 Severity can range from pupillary strands or an isolated Mittendorf dot, to more severe forms with retrolenticular membranes, retinal dysplasia, or detachment. 1, 3, [doi.org]

In a retrospective chart review of patients younger than 40 years, angle closure was found to be more frequently associated with structural or developmental abnormalities [doi.org]

Methanol Poisoning

Pupillary abnormality was observed in all. Edema of the optic disc and nerve fiber layer were common fundus findings. [ncbi.nlm.nih.gov]

Subarachnoid Hemorrhage

Urgent salvage procedures to evacuate parenchymal haematomas (before DSA investigation) is reserved for states of acute intracranial decompensation and pupillary abnormalities [jnnp.bmj.com]

The level of coma and pupillary abnormalities in poor grade patients should largely be ignored in the early phases of resuscitation, as they are often unreliable for prognostic [jnnp.bmj.com]

Acute Angle Closure Glaucoma

Causes of Narrow-Angle Glaucoma Causes of the abnormal positioning of the iris in narrow-angle glaucoma include: Pupillary block. [allaboutvision.com]

Angle crowding — this may occur due to an abnormally configured iris, e.g. plateau iris, that obstructs the angle during pupillary dilatation. [lifeinthefastlane.com]

Pupillary block occurs when aqueous humor cannot pass from the posterior to the anterior chamber because of iridolenticular apposition. [journal.opted.org]

Iritis

Most of the small nodules were situated in the pupillary part of the iris resulting in dilatation and abnormal permeability of all the peripupillary vessels. [ncbi.nlm.nih.gov]

A B C D E F G H I K L M N O P R S T U V W X Abnormalities, Eye (Eye Abnormalities) Acanthamoeba Keratitis Achromatopsia (Color Vision Defects) Acute Hemorrhagic Conjunctivitides [provisu.ch]

(Conjunctivitis, Acute Hemorrhagic) Acute Retinal Necrosis (Retinal Necrosis Syndrome, Acute) Adie Syndrome Adie's Pupil (Tonic Pupil) Afferent Pupillary Defect (Pupil Disorders [provisu.ch]

Brain Abscess

There was pupillary abnormality in 11 cases. [npplweb.com]

Coloboma

Anterior segment examination was normal with no pupillary abnormality. The intraocular pressures were 14 mmHg in each eye. [njcponline.com]

A B C D E F G H I K L M N O P R S T U V W X Abnormalities, Eye (Eye Abnormalities) Acanthamoeba Keratitis Achromatopsia (Color Vision Defects) Acute Hemorrhagic Conjunctivitides [provisu.ch]

(Conjunctivitis, Acute Hemorrhagic) Acute Retinal Necrosis (Retinal Necrosis Syndrome, Acute) Adie Syndrome Adie's Pupil (Tonic Pupil) Afferent Pupillary Defect (Pupil Disorders [provisu.ch]

Vitreous Hemorrhage

A B C D E F G H I K L M N O P R S T U V W X Abnormalities, Eye (Eye Abnormalities) Acanthamoeba Keratitis Achromatopsia (Color Vision Defects) Acute Hemorrhagic Conjunctivitides [provisu.ch]

(Conjunctivitis, Acute Hemorrhagic) Acute Retinal Necrosis (Retinal Necrosis Syndrome, Acute) Adie Syndrome Adie's Pupil (Tonic Pupil) Afferent Pupillary Defect (Pupil Disorders [provisu.ch]

Intracranial Hematoma

Its features are: Hypertension Bradycardia Abnormal respiratory patterns Other signs of imminent herniation are lack of pupillary reaction and/or pupillary asymmetry. [cdemcurriculum.com]