This document discusses anisocoria, or unequal pupil size between the two eyes. It begins by defining anisocoria and outlining the normal sympathetic and parasympathetic pathways that control pupil size. It then distinguishes between physiological anisocoria, which can occur normally, and pathological anisocoria, which can be due to local factors affecting just one eye or defects in the sympathetic or parasympathetic nervous systems controlling both eyes. The document concludes by listing questions doctors should consider when examining a patient with anisocoria.

1. ANISOCORIA
DR SIVATEJA CHALLA

2. • DEFINITION
• NORMAL PUPIL PATHWAYS
SYMPATHETIC PATHWAY
PARASYMPATHETIC PATHWAY
• PHYSIOLOGICAL ANISOCORIA
• PATHOLOGICAL ANISOCORIA
1.DUE TO LOCAL FACTORS
2.DUE TO DEFECT IN SYMPATHETIC SYSTEM
3.DUE TO DEFECT IN PARASYMPATHETIC SYSTEM

3. DEFINITION

4. PUPILLARY PATHWAYS

5. SYMPATHETIC PATHWAY

6. PARASYMPATHETIC PATHWAY

7. PHYSIOLOGICAL ANISOCORIA

8. PATHOLOGICAL ANISOCORIA

9. DUE TO LOCAL FACTORS

11. ANISOCORIA INCREASING IN DIM
LIGHT

18. ANISOCORIA INCREASING IN
BRIGHT LIGHT

22. CONCLUSIONS
• Is the anisocoria greater in dim light or bright light?
• Is the pupillary reaction to light normal in each eye?
• Is there a light–near dissociation?
• Is there ptosis or abnormal ocular motility?
• Are iris abnormalities noted at the slit lamp?

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