Symptom >> Otorhinolaryngology >> Ophthalmology

The pupils are unequal on both sides

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction Due to the phenomenon of light reflection, it is indicated that the size of the bilateral pupils of the normal person and the stretching ability should be identical. Only when the object is viewed on the side of the frequently used side will produce eye deformation, such as different degrees of myopia in both eyes, and when the difference is more than 200 degrees, wearing the eye for a long time causes the deformation of the eye to cause the pupils on both sides to be different, and may also be the following four cases. : First: It may be a physiological developmental malformation caused by congenital inheritance. Second: It may be that the injury caused growth abnormalities. Third: pharmacological lesions produced by the use of adverse drugs. Fourth: the growth of foreign bodies in the eye causes oppression of the eye.

Cause

Cause

The cause is still unclear. The lesion may be in:

1 ciliary ganglia and ciliary nerve, or lesions in or near it;

2 upper cervical cord lesions;

3 ocular nucleus lesions.

However, why this syndrome is accompanied by the disappearance of knee reflex, the mechanism is still unknown.

Examine

an examination

Related inspection

Ultrasound examination of the eyeball and eyelid by CT in the eye and temporal region

Most occur in women under the age of 30. The main symptoms are the loss of pupil and knee reflex. It manifests as a dilated pupil on one side, and the photoreaction and regulation response disappear. However, if the glare is continuously irradiated for more than half a minute, the pupil may be slowly reduced; if the eyes are concentrated for five minutes, the pupil may be slowly contracted. This phenomenon is also known as Adie's pupil or tonic pupil. Adie classifies the syndrome as follows:

(1) The pupil type of the complete type of pupil and the knee reflex disappear.

(2) There are four cases of incomplete type:

1. Only the pupil is strong;

2. Unshaped pupillary rigidity (iris paralysis);

3. Knee tendon reflex disappears with undefined pupil stiffness;

4. Only the knee reflex disappears.

Diagnosis

Differential diagnosis

Pupil deformation refers to abnormal morphology of the pupil, or abnormal response of the pupils on both sides. Normally round, both sides are equal, and the responses of the pupils on both sides are synchronized. It can be elliptical in glaucoma or intraocular tumors; the shape can be irregular when the iris is stuck.

Pupil asymmetry: normal adult pupils 3 to 4 mm, bilateral and other large circles, sensitive to light. Patients with cerebrovascular disease often have pupillary changes in the acute phase. It is characterized by bilateral pupil asymmetry, or bilateral pupil dilation, bilateral pupil dilation, these changes are the reflection of different parts of the lesion on the pupil. Therefore, when the pupil asymmetry occurs, it should be identified that the small side of the pupil is the lesion side, or the larger side is the lesion side.