Light Near Dissociation in a Tonic Pupil

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Identifier Light_near_dissociation_in_a_tonic_pupil
Title Light Near Dissociation in a Tonic Pupil
Alternative Title Video 2.3 Clinical features of a tonic pupil from Neuro-Ophthalmology and Neuro-Otology Textbook
Creator Daniel R. Gold, DO
Affiliation (DRG) Departments of Neurology, Ophthalmology, Neurosurgery, Otolaryngology - Head & Neck Surgery, Emergency Medicine, and Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland
Subject Tonic Pupil
Description ๐—ข๐—ฟ๐—ถ๐—ด๐—ถ๐—ป๐—ฎ๐—น ๐——๐—ฒ๐˜€๐—ฐ๐—ฟ๐—ถ๐—ฝ๐˜๐—ถ๐—ผ๐—ป: This is a 65-year-old woman who noticed difficulty reading and heightened sensitivity to lights OS for the last 6 months. On examination, there was mydriasis OS of about 6 mm (3 mm OD). The left (mydriatic) pupil constricted minimally to light, but constricted much better to a near stimulus. When looking back to a distant target, the pupil was slow to dilate (i.e., a โ€˜tonic' dilation). During slit lamp examination, there was sectoral constriction of the left pupil, with the inferior iris constricting much more than the superior segment. Upon review of old photos, there was relative mydriasis OS for at least 12 months. Examination of motility and eyelid function was unremarkable with normal alignment and no ptosis. Deep tendon reflexes were normal (i.e., this was not Adie's syndrome). There was constriction OS (but not OD) with dilute (0.1%) pilocarpine, and she was diagnosed with a left tonic pupil. She was given a higher power prescription for reading OS, and over years the left pupil spontaneously became less mydriatic. ๐—ก๐—ฒ๐˜‚๐—ฟ๐—ผ-๐—ผ๐—ฝ๐—ต๐˜๐—ต๐—ฎ๐—น๐—บ๐—ผ๐—น๐—ผ๐—ด๐˜† ๐—ฎ๐—ป๐—ฑ ๐—ก๐—ฒ๐˜‚๐—ฟ๐—ผ-๐—ผ๐˜๐—ผ๐—น๐—ผ๐—ด๐˜† ๐—ง๐—ฒ๐˜…๐˜๐—ฏ๐—ผ๐—ผ๐—ธ ๐—Ÿ๐—ฒ๐—ด๐—ฒ๐—ป๐—ฑ: This video depicts the common features of a tonic pupil, including poor pupil reactivity to light and better constriction to a near stimulus, as well as a tonic (slow) dilation of the affected pupil when looking from near to distance. https://collections.lib.utah.edu/ark:/87278/s61p390k
Date 2020-04
Language eng
Format video/mp4
Type Image/MovingImage
Collection Neuro-Ophthalmology Virtual Education Library: Dan Gold Collection: https://novel.utah.edu/Gold/
Publisher North American Neuro-Ophthalmology Society
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management Copyright 2016. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s61p390k
Setname ehsl_novel_gold
ID 1540450
Reference URL https://collections.lib.utah.edu/ark:/87278/s61p390k
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