Bilateral Dilated Pupils Unresponsive to Light and with Intact Convergence and Accommodation but No Pupillary Miosis

Pupillary enlargement can be caused by damage to the sphincter, ciliary ganglion, short ciliary nerves or the third cranial nerve. If the ciliary ganglion or nerves are affected, the pupil is tonic, demonstrates light-near dissociation and is supersensitive to dilute pilocarpine. Pupillary enlargement can occur with increased sympathetic tone, but the pupil would be round and accommodation intact.