UNEQUAL PUPILS

1. ANISOCORIA
DR SIVATEJA CHALLA

2. • DEFINITION
• NORMAL PUPIL PATHWAYS
SYMPATHETIC PATHWAY
PARASYMPATHETIC PATHWAY
• PHYSIOLOGICAL ANISOCORIA
• PATHOLOGICAL ANISOCORIA
1.DUE TO LOCAL FACTORS
2.DUE TO DEFECT IN SYMPATHETIC SYSTEM
3.DUE TO DEFECT IN PARASYMPATHETIC SYSTEM

3. DEFINITION

4. PUPILLARY PATHWAYS

5. SYMPATHETIC PATHWAY

6. PARASYMPATHETIC PATHWAY

7. PHYSIOLOGICAL ANISOCORIA

8. PATHOLOGICAL ANISOCORIA

9. DUE TO LOCAL FACTORS

11. ANISOCORIA INCREASING IN DIM
LIGHT

18. ANISOCORIA INCREASING IN
BRIGHT LIGHT

22. CONCLUSIONS
• Is the anisocoria greater in dim light or bright light?
• Is the pupillary reaction to light normal in each eye?
• Is there a light–near dissociation?
• Is there ptosis or abnormal ocular motility?
• Are iris abnormalities noted at the slit lamp?

23. THANK YOU