ANISOCORIA

Pembimbing:
dr. Donny H Hamid, SpS
Disusun oleh :
Danita Dwi Maryana
1102011070

PUPIL

Sphincter
pupillae
Dilator pupillae

Ciliary muscle

OPTIC NERVE

OCULOMOTORIUS NERVE

Pupillary Light Reflex

The afferent and efferent

parasympathetic pathway

Oculosympathetic pathway

Mechanisme of Accommodation
If the eyes staring at an object that is moving closer, then the events
as follows:
Contraction of the medial rectus muscle of both eyes for a
convergence eyes axis
Thickening of the lens by ciliaris muscle to increase the refractive
power
Pupillary constriction to limit incoming light

ANISOCORIA PUPIL
Definition
Anisocoria terms derived from the Greek word literally means
unequal pupil size. anisocoria was defined as a pupillary inequality of
greater than, or less than, 0.4 mm.
Epidemiology
Up to 20% of the general population
has physiologic anisocoria.

Examination

Pupil Light Reflex

Swinging
Flashlight

Accommodation

Etiology and Classificated

Anisocoria

Physicological

Patological

Afferent
defect

Central defect

Efferent
defect

Treatment
In cases where the condition is caused by particular pharmacological drugs like asthma

inhalers or eyedrop, it may be possible that doing away with the medication will remedy
the condition.
When anisocoria is suspected to be resulting from Horners syndrome, the medical
practitioners or ophthalmologists will search for this disorder using a ten percent cocaine
solution. If detected, a number of treatment pathways would be suggested depending on
what caused the syndrome. In case the condition is resulting from a recent stroke, then its
cause has to be treated. In case there is a tumor either along ones cervical spine or in
your lung, consulting an oncological specialist would be important.
Diagnosing and repairing the mechanical damage of the iris- anisocoria may result from
traumatized, torn or inflamed iris especially in case you have undergone surgery in the
recent times. The inflammation may be taken care of by taking medication if the cause is
a mechanical issue. In cases where traumatic damage is the cause, the medical
practitioner may advice you to give it some time to heal.
Treating the oculomotor nerve palsy- the medical practitioners would device as well as
execute a therapy plan.
Treating swelling of the brain tissue or the brain- cortisone shots may be recommended for
in on your face or other areas. This reduces the inflammation thereby causing the normal
size of the pupils to be regained.

Clinical disease

Horners
Syndrome

AdieTonic Pupil

Agryll Robertson
pupil

Oculomotor Nerve
Palsy

Horners Syndrome

Etiology

Argyll Robertson Pupil

Etiology

Adies Tonic Pupil

Etiology

Third Nerve (Oculomotorius)

Palsy

Etiology

References
1. Bremner, F.D. Pupil Abnormalities. OT 2000; 2: 32-38.
2. Andreassi J. Pupillary Response and Behavior. Pyschophysiology: Human Behavior & Physiological
Response.2013. Mahwah, NJ: Lawrence Erlbaum Assoc.
3. Millodot. Dictionary of Optometry and Visual Science, 7th edition. 2009. Butterworth-Heinemann.
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Mei 2015.
5. Friedman, N.J., and Kaiser P.K. 2007. Essential of Opthalmology. USA: Elsevier.
6. Bournias, T.E. 2004. Neuro Opthalmology, Chapter 6. In: Opthalmology. USA: Blackwell Publishing.
7. Kenneth, W.L., and Bone I. 1997. Neurology and Neurosurgery Illustrated. UK: Churchill Livingstone.
8. Lam, B.L., Thompson H.S., and Corbett J.J. 1987. The Prevalance of Simple Anisocoria. Am J Opthalmol 104(1):
69-73.
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2010, Jakarta.
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http://differentialdiagnosisoftos.weebly.com/horners-syndrome.html Diakses pada tanggal 9 Mei 2015.
12.Diunduh dari http://www.scielo.br/scielo.php?script=sci_arttext&pid. Diakses pada tanggal 9 Mei 2015.
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2015.
14. Cranial Nerves. Diunduh dari http://www.blackwellpublishing.com Diakses pada tanggal 9 Mei 2015.
15. Pupillary Responses. Diunduh dari http://www.neuroexam.com/neuroexam diakses pada tanggal 10 Mei 2015
16. Anisocoria. Diunduh dari http://www. primehealthchanel.com Diakses pada tanggal 10 Mei 2015.