Discussions By Condition: I cannot get a diagnosis.

Pupil disorders

Posted In: I cannot get a diagnosis. 2 Replies
  • Posted By: Anonymous
  • January 2, 2007
  • 08:29 PM

I am looking for a provisional diagnosis for this patient:
A 55 year old male attends for an eye examination complaining of a difference in pupil size in the last few weeks where he was prescribed glasses for reading only. His general health is good although is aware of an itchy rash on his right cheek. He is a heavy smoker and takes medication for high blood pressure which he thinks is controlled.
Ophthalmoscopy is normal
Refraction reveals: RE +0.50/-0.25x85 6/6 Add +1.00 N5
LE:+0.25/-0.25x95 6/5 Add +2.00N5
Pupils: Right pupil smaller than Left, appears to react normally.
IOP: R 10mmHg L 14 mmHg NCT @12pm

I am unsure whether it is the RE or LE that is affected and therefore can not confirm which of the pupil disorders he is suffering from. Since there is normal pupil responses i am currently thinking either Physiological anisocoria or Horners syndrome.
Someone please help!:)

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2 Replies:

  • My pupils have behaved oddly for 4+ years now, and I haven't been able to find a diagnosis for it, either. They are often different sizes, though the difference is not constant, nor consistent (ie, one day it'll be the right that's larger, then the left, then a day with no irregularities, etc). They are often off centered as well, with more of the iris below the pupil than above, or more iris towards the outside of the eye than towards my nose, but again, it changes with the day. They have always reacted normally to light, and optometrists and ophthalmologists haven't found anything wrong. I have also seen half a dozen neurologists for my other health issues, and they have all dismissed it as a non-issue.I've been focused on getting a diagnosis and proper treatment for my other health issues, but I am still curious about what causes that sort of pupil abnormality. Please do post here if you find anything out about this.~Ryot
    Anonymous 42789 Replies
    • January 3, 2007
    • 01:54 AM
    • 0
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  • u cheater. zxfvbxzxzbzcxncxznxcnvcxnxcbnxcnxcncxnxfcnxcn
    Anonymous 42789 Replies
    • January 10, 2007
    • 05:01 PM
    • 0
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