| 词条 | Anisocoria |
| 释义 |
| name = Anisocoria | synonyms = | image = Anisocoroa.jpg | caption = A large difference in the size of the pupils following application of Tropicamide in the right eye only. | pronounce = {{IPAc-en|æ|n|ˌ|aɪ|s|oʊ-|ˈ|k|ɔːr|i|ə}} | field = | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }} Anisocoria is a condition characterized by an unequal size of the eyes' pupils. Affecting 20% of the population, it can be an entirely harmless condition or a symptom of more serious medical problems. CausesAnisocoria is a common condition, defined by a difference of 0.4 mm or more between the sizes of the pupils of the eyes.[1] Anisocoria has various causes:[2]
Diagnostic approachCauses of anisocoria range from benign (normal) to life-threatening conditions. Clinically, it is important to establish whether anisocoria is more apparent in dim or bright light to clari larger pupil or smaller pupil is the abnormal one.
A relative afferent pupillary defect (RAPD) also known as a Marcus Gunn pupil does not cause anisocoria. Some of the causes of anisocoria are not life-threatening, including Horner's syndrome (which may be due to carotid artery dissection) and oculomotor nerve palsy (due to a brain aneurysm, uncal herniation, or head trauma). If the examiner is unsure whether the abnormal pupil is the constricted or dilated one, and if a one-sided drooping of the eyelid is present then the abnormally sized pupil can be presumed to be the one on the side of the ptosis. This is because Horner's syndrome and oculomotor nerve lesions both cause ptosis. Anisocoria is usually a benign finding, unaccompanied by other symptoms (physiological anisocoria). Old face photographs of patients often help to diagnose and establish the type of anisocoria. It should be considered an emergency if a patient develops acute onset anisocoria. These cases may be due to brain mass lesions which cause oculomotor nerve palsy. Anisocoria in the presence of confusion, decreased mental status, severe headache, or other neurological symptoms can forewarn a neurosurgical emergency. This is because a hemorrhage, tumor or another intracranial mass can enlarge to a size where the third cranial nerve (CN III) is compressed, which results in uninhibited dilatation of the pupil on the same side as the lesion.[7] Popular culture• English singer David Bowie exhibited anisocoria, owing to a teenage injury.[8] Actor Judd Hirsch also has this condition. • In the season 10 Big Bang Theory Comic-Con special, Steve Molaro told a story about how he first met Judd Hirsch and was taken aback by his dilated pupil. One of the other writers researched it and discovered that Judd Hirsch has anisocoria. • American actress Melissa Benoist developed this condition after she hit her eye on a potted plant after falling downstairs.[9]{{Failed verification|reason=Pupil size is not mentioned. It says she tore her iris|date=December 2018}} EtymologyAnisocoria is composed of prefix, root and suffix:
Thus, anisocoria means the condition of unequal pupil(s). See also
References1. ^{{cite journal|last=Lam|first=BL|author2=Thompson, HS|author3= Corbett, JJ|title=The prevalence of simple anisocoria.|journal=American Journal of Ophthalmology|date=Jul 15, 1987|volume=104|issue=1|pages=69–73|pmid=3605282|doi=10.1016/0002-9394(87)90296-0}} 2. ^{{cite book|author1=John P.Whitcher |author2=Paul Riordan-Eva |title=Vaughan & Asbury's general ophthalmology.|publisher=McGraw-Hill Medical|isbn=978-0071443142|page=293|edition=17th }} 3. ^{{cite journal|last=London|first=Richard|first2=Ellen |last2=Richrer Erringer |first3=Harry J. |last3=Wyafr|title=Variation and Clinical Observation With Different Conditions of Illumination and Accommodation|journal=Investigative Ophthalmology & Visual Science|date=March 1991|volume=32|issue=3|pages=501–9}} 4. ^Anisocoria. Medscape Reference. Accessed April 15, 2012. 5. ^. It is also seen in some people who consume diphenydramine (brand name "Benadryl") for an extended period of time, or if an astringent eye drop like Visine is used in one eye and not the other, often in concurrence with the presence of contact lenses.{{ Citation| last1 = van der Donck| first1 = I.| last2 = Mulliez| first2 = E.| last3 = Blanckaert| first3 = J.| title = Angel's Trumpet (Brugmansia arborea) and mydriasis in a child - A case report| journal = Bulletin de la Societe Belge d'Ophtalmologie| volume = 292| pages = 53–56| year = 2004| url = http://www.ophthalmologia.be/download.php?dof_id=223| issn = 0081-0746 }} 6. ^{{cite web|title=Anisocoria Differential Diagnoses|url=http://emedicine.medscape.com/article/1158571-differential|website=emedicine.medscape.com|accessdate=3 June 2017|language=en}} 7. ^{{cite web|last=Medscape|first=online|url=http://emedicine.medscape.com/article/1158571-clinical#a0218|accessdate=25 November 2012|title=Anisocoria Clinical Presentation}} 8. ^{{cite web |url=https://theconversation.com/the-remarkable-story-behind-david-bowies-most-iconic-feature-52920 |title=The remarkable story behind David Bowie’s most iconic feature |last=Hunt |first=Kevin |date=January 11, 2016 |work=The Conversation |accessdate=January 17, 2016}} 9. ^{{cite web |url = https://ew.com/article/2016/03/19/supergirl-melissa-benoist-jimmy-fallon-tonight-show/|title=Supergirl: Melissa Benoist, Jimmy Fallon talk cab story on The Tonight Show}} Further reading
External links{{Medical resources| DiseasesDB = 724 | ICD10 = {{ICD10|H|57|0|h|55}} | ICD9 = {{ICD9|379.41}} | ICDO = | OMIM = 106240 | MedlinePlus = 003314 | eMedicineSubj = emerg | eMedicineTopic = 29 | eMedicine_mult = {{eMedicine2|neuro|479}} {{eMedicine2|oph|160}} | MeshID = D015875 }}{{Eye pathology }} 2 : Diseases of the eye and adnexa|Oculomotor nerve |
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