Anisocoria

Description:

Anisocoria — the symptom which is characterized by the different size of pupils of the right and left eye.

Anisocoria symptoms:

It is clinically important to establish what of pupils is in morbid condition. If smaller of two pupils does not react to decrease in brightness of light (does not extend in a twilight), it can testify to insufficiency of a sympathetic innervation as, for example, at Horner's syndrome. If, pathological is a pupil of bigger diameter, that is it does not react to increase in brightness of light, it is necessary to think of insufficiency of a parasympathetic innervation, for example at pathology of a third cranial nerve. The symptom of the Hun  (Marcus Gunn) at which strengthening of a consensual photoharmose on a sore eye (is observed at defeat of afferent nerve pathways), does not cause an anisocoria. At an anisocoria it is necessary to define what of eyes is patholologically expanded or narrowed. The simultaneous ptosis of an upper eyelid as, for example, at Horner's syndrome or at pathology of a third cranial nerve is a sign of pathology.

Anisocoria reasons:

In the absence of any damages of an iris of the eye or eyeglobe the anisocoria usually is a consequence of defeat of efferent nerve fibrils (a parasympathetic innervation) in the third cranial nerve controlling the movements of a pupil or the sympathetic nerve fibrils going from the ciliospinal center. The anisocoria is a component of a syndrome of Adee  and Argayl Robertson's syndrome. Some drugs and psychoactive agents can influence a pupil, for example, Pilocarpinum, cocaine, тропикамид, amphetamines (for example, "ecstasy"), Scopolaminum. Similar to these the alkaloids which are contained in plants of family of a nightshade family can cause an anisocoria also. The anisocoria — a compound symptom, it consists of two opposite actions of a pupil: a miosis (narrowing of a pupil concerning norm) and a mydriasis (respectively, expansions).
The anisocoria is found at:
    * use of drugs
    * hemorrhage (traumatic hematomas (epidural, subdural)) or the tumors pressing on nerve pathways or the visual centers;
    * disturbances of cerebral circulation;
    * infections: neurosyphilis, epidemic encephalitis;
    * diseases of the internals which are not involving system of an innervation of an eye, and operating reflex (the tuberkuleena defeat of a top of a lung (Roque's symptom), diseases of abdominal organs);
    * diseases of an iris of the eye.
    * to a stupid injury of an eye with damage of a sphincter of a pupil;
    * inborn.

If the anizikoriya is combined with an acute severe headache, mental disorders, the confused consciousness, it can demonstrate heavy pathological process in a brain which demands emergency medical service, and, perhaps, urgent surgical intervention.

Treatment of the Anisocoria:

Treatment of a basic disease against the background of which the anisocoria is observed is carried out.