Taking the Mystery out of Abnormal Pupils. Brad Sutton, O.D., F.A.A.O. IU School of Optometry Indianapolis Eye Care Center. Review of Anatomy. Iris sphincter Iris dilator Parasympathetic pathway Sympathetic pathway . Iris anatomy. Parasympathetic Pathway.
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Brad Sutton, O.D., F.A.A.O.
IU School of Optometry
Indianapolis Eye Care Center
Some cause mydriasis, some cause miosis!
Permethrin: found in some sprays. Has sympathetic effects (dilation, normal near vision)
Anticholinesterase products found in collars, powders, and foggers: heightened parasympathetic effect (miosis, accom. spasm)Pharmacology
Severe lethargy with bradycardia and decreased respiration
Several cases reported where hospitalization with oxygen was requiredApraclonidine side effects
Stroke of vertebral or posterior inferior cerebellar artery in the brainstem
Uncontrollable hiccupsWallenberg’s syndrome
Abnormally Large Pupil in the brainstem
CN III Palsy
Acute Adie’s tonic pupil
Abnormally Small Pupil