A presentation by Dr. Soundari from Dr. Agarwals eye hospital on Pupil, in kalpavriksha , Chennai

1. Dr. S. Soundari
Consultant ophthalmologist
Dr Agarwal’s eye hospital, chennai

5. DILATED PUPIL CONSTRICTED PUPIL
 Well appreciated in bright  Well appreciated in dim
light light
 Causes  Causes
 RAPD HORNERS
 ADIES  ARGYLL ROBERTSON PUPIL
 TRAUMATIC
 PHARMACOLOGICAL
 THIRD NERVE PALSY
 PHARMACOLOGICAL

10.  Bilateral Optic nerve pathology
 Normal- 840msec
 Abormal:
 Difference between two pupils-70msec
 More than 954 msec

11.  Large unilaterally dilated pupil
 Absent or poor light response
 Near slow tonic contraction
 Absence of deep tendon reflex- home’s
adies syndrome.

18.  EOM affected
 Can be Pupil involving or Pupil sparing

20.  Pseudoargyll robertsons pupil
 Pupillary constriction on looking down

21.  Does not respond to 2% pilocarpine as
the receptors are blocked
 Example: atropine,
homatropine,cyclopent

27.  Miosis
 Partial ptosis
 Inverse ptosis
 Enophthalmos
 Anhydrosis
 Loss of ciliospinal reflex

29.  Hetrochromia Iridis
 Low IOP

30.  Normal pupil dilates
 Horners pupil does not
 Mechanism- prevents re-uptake of
norepinephrine

31.  PREGANGLIONIC Dilates
 Mechanism- releases the norepinephrine

32.  POSTGANGLIONIC Dilates
 Mechanism- denervation supersentivity

35.  Both pupil miotic assymmetric
 Light reflex absent
 Accomodation reflex present

36.  Causes:
 Argyll Robertson Pupil
 Adies Pupil
 Diabetes
 Alcoholism
 Parinauds Syndrome

38. ECCENTRIC PUPIL ICE SYNDROME