Pupillary Abnormalities

Front 1

Unequal Pupils / Larger pupil cannot constrict properly / Caused by blunt trauma to the eye, open angle glaucoma, impaired parasympathetic nerve supply to the iris (Tonic pupil & Oculomotor Nerve Paralysis) /

Back 1

Aniscoria in Bright Light

Front 2

Unequal Pupils / Smaller pupil cannot dilate properly / Caused by Horner's Syndrome or an interruption of the sympathetic nerve supply

Back 2

Aniscoria in Dim Light

Front 3

Pupil is Large, regular, and unilateral / Reaction to light is severely reduced, slowed or absent / Near Reaction is present but slow / Slow accomodation causes blurred vision / Deep tendon reflexs are often decreased

Back 3

Tonic Pupil (Adie's Pupil)

Front 4

Dilated Pupil (6-7 mm) fixed to light and near effort / Pitosis and lateral deviation of the eye are sometimes present / More dilated pupil could result from atropine eyedrops

Back 4

Oculomotor Nerve (III) Paralysis

Front 5

Small pupil reacts to light quickly / Pitosis is present sometimes accompanied by loss of sweating on the forehead / If congenital would cause involved iris to be lighter in color (Heterochromia)

Back 5

Horner's Syndrome

Front 6

Small, irregular pupils that accommodate but do not react to light / Seen in CNS Syphillis

Back 6

Argyll Robertson Pupils

Front 7

Unilateral Blindness does not cause Aniscoria as long as sympathetic and parasympathetic innervation to both irises is normal / Light shown in seeing eye produces a direct reaction in that eye and a consensual reaction in the blind eye / Light shown in blind eye causes no response in either eye

Back 7

Equal Pupils & One Blind Eye