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Pupil

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

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Pupil

  1. 1. Dr. S. Soundari Consultant ophthalmologistDr Agarwal’s eye hospital, chennai
  2. 2. 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
  3. 3.  Bilateral Optic nerve pathology Normal- 840msec Abormal: Difference between two pupils-70msec More than 954 msec
  4. 4.  Large unilaterally dilated pupil Absent or poor light response Near slow tonic contraction Absence of deep tendon reflex- home’s adies syndrome.
  5. 5.  EOM affected Can be Pupil involving or Pupil sparing
  6. 6.  Pseudoargyll robertsons pupil Pupillary constriction on looking down
  7. 7.  Does not respond to 2% pilocarpine as the receptors are blocked Example: atropine, homatropine,cyclopent
  8. 8.  Miosis Partial ptosis Inverse ptosis Enophthalmos Anhydrosis Loss of ciliospinal reflex
  9. 9.  Hetrochromia Iridis Low IOP
  10. 10.  Normal pupil dilates Horners pupil does not Mechanism- prevents re-uptake of norepinephrine
  11. 11.  PREGANGLIONIC Dilates Mechanism- releases the norepinephrine
  12. 12.  POSTGANGLIONIC Dilates Mechanism- denervation supersentivity
  13. 13.  Both pupil miotic assymmetric Light reflex absent Accomodation reflex present
  14. 14.  Causes: Argyll Robertson Pupil Adies Pupil Diabetes Alcoholism Parinauds Syndrome
  15. 15. ECCENTRIC PUPIL ICE SYNDROME

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