Neuroimaging is not necessarily required if the patient is female, has a history of previous episodes and/or migraines, and the dilated pupil is the only ocular finding. The dilated pupil will constrict to 1% pilocarpine, in contrast to a pharmacologically dilated pupil. Specifically, no ptosis or EOM involvement is found and the patient may report previous episodes. The dilated pupil is intermittent, lasting for hours to days, and is the only ocular finding. A brain MRI and MRA were both negative.īenign episodic unilateral mydriasis is most commonly seen in women with a history of migraines. She reported experiencing a migraine 24 hours after our visit and resolution of the dilation after 48 hours. Boxer Wachler explains, Without being dilated with eye drops, if one pupil is dilated and not responsive to light, this could be from a brain tumor. The patient followed up in 3 days at our office and presented at that time with normal pupils (see the second photo). However, when someone notices that one pupil is bigger than the other, there may be no recent history of optometrist eye drops to dilate the pupil. Given the otherwise normal examination and history of migraines, the patient was diagnosed with benign episodic unilateral mydriasis (BEUM). The attached photo shows the pupils at presentation. The BVA was slightly decreased at distance OS (20/25) and near (J2). Examination was negative for a reverse APD, diplopia, EOM involvement, or ptosis. Scintillating scotomas, demographics, and history are the key. Otherwise, the patient, who has a history of migraines, was asymptomatic including a lack of headache at the time of presentation. A few hours earlier the patient noted a loss of focusing ability and dilation in the left eye only. A 32-year-old Caucasian female was referred for a unilateral, dilated pupil.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |