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this is Holmes Adie pupil. its a benign disorder,usually affect young women and result in a large pupil which is regular or circular. the condition is associated with absent ankle jerk.
I agree it is difficult to make proper diagnosis from just a picture. the question really is which is the abnormal eye?! is it dilated left or costricted right? on balance we went for dilated right in view of absence of ptosis and the fact that she appear to be young lady. what do others think?
i will 1st examin light and accomodation reflex to determined it?In horner all present but in homles adie there is slow responce specially to light reflex.
Generally, in bright light dilated pupil will be abnormal(because normal pupil will constrict) while in dim light small pupil will be abnormal(because normal pupil will dilate).So in this case left pupil is abnormal and most likely Holmes Adie pupil.
this is Holmes Adie pupil.
ReplyDeleteits a benign disorder,usually affect young women and result in a large pupil which is regular or circular.
the condition is associated with absent ankle jerk.
other causes od dilated pupil:
ReplyDelete1 mydriatic eye drop
2 the nerve lesion
3 lens implant
4 deep coma
5 death
I disagree with Holmes Adie...I think its Rt.sided Horner's
ReplyDeleteI agree it is difficult to make proper diagnosis from just a picture.
ReplyDeletethe question really is which is the abnormal eye?!
is it dilated left or costricted right?
on balance we went for dilated right in view of absence of ptosis and the fact that she appear to be young lady.
what do others think?
It's Holmes Adie
ReplyDeleteDD for Mydriasis
Third nerve palsy-surgical v DM
Ethylene glycol poisoning
Argyll Robertson
Carbon monoxide
Holmes Adies
TEACH!
i will 1st examin light and accomodation reflex to determined it?In horner all present but in homles adie there is slow responce specially to light reflex.
ReplyDeletei thinck in argyl its constricted and irreguler not dilated
ReplyDeleteI agree.Argyll Robertson pupil is in the differential diagnosis of small pupil(not Mydriasis).
ReplyDeleteWell I suggest its right eye congenital horners syndrome as evident by iris heterochromia
ReplyDeleteGenerally, in bright light dilated pupil will be abnormal(because normal pupil will constrict) while in dim light small pupil will be abnormal(because normal pupil will dilate).So in this case left pupil is abnormal and most likely Holmes Adie pupil.
ReplyDeletecould it be left sided optic atrophy. multiple sclerosis. young lady
ReplyDeleteHeterochromia iridis with congenital horners
ReplyDelete