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Ophthalmology Neuro-ophthalmology 48f679e7

In case of anisocoria when 1% pilocarpine is instilled into the eye with abnormally dilated pupil, pupil remains dilated. Cause of anisocoria maybe-

A
Adies pupil
B
Pharmacological blockage
C
Uncal herniation
D
Diabetic III cranial nerve palsy
High-Yield Explanation
Pharmacological tests for suspected parasympathetic palsy. Pilocarpine test is used to determine if a dilated pupil is due to 3rd nerve palsy, pharmacological mydriasis, or tonic pupil. Pupil constricts to low concentration of pilocarpine (0.125%): Adies tonic pupil. Pupil constricts to usual concentration of pilocarpine (1 to 2%): 3rd nerve palsy. Pupil does not constrict with pilocarpine: mydriasis due to parasympathetic drugs, other conditions where dilated pupil does not constrict with pilocarpine are traumatic mydriasis and fixed pupil in irits. Ref AK khurana 6/e p 317

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