unequal pupils

[Guest guest]

I have a patient with genetically different pupil sizes. I remember my fears when she came in following an auto accident. She said that other docs had seen this as well all her life. Once I checked with her PCP, I was satisfied. Was your employee like this prior to the cold? Or did you ever have occasion to examine her pupillary responses? Did she cough a lot? Could there be a vascular (intrathecal pressure induced) cause? Are consensual responses normal in spite of the differing pupil sizes? That's an important finding.

Minga Guerrero DC

In a message dated 12/26/2007 11:16:09 AM Pacific Standard Time, twogems@... writes:

Docs:I have an employee who was out sick (head cold, etc.) for about a week and just returned today. While listening to her description of how she's been feeling, I noticed that her left pupil is dilated compared to the right. She's on antibiotics, but I don't recall ever hearing that those could cause something like that. She hasn't had any head trauma...just a lot of coughing lately. She says she's never had syphilis, so we can hopefully rule our Argyll on pupil. The only thing I can find in my Merck manual is Adie Syndrome, usually affecting women between the ages of 20 and 40 (she's 55), and there is no known cause and no cure.Anybody have any other ideas what might be going on?Lyndon McGill, D.C.Salem, Oregon

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[Guest guest]

The few unequal size pupils I have seen have all been related to

pathological brain conditions, proven at neurological work up.

I'm sure you will want to explore the various potentials closely.

yours in health,

Jack Pedersen DC

[Guest guest]

After a head cold, it is not unusual to find derangement of the sphenobasilar and all sinus and orbital compartments, subneurologically changing/challenging the cranial nerves. The question would be, what does she do after adjusting the cranial distortion a head cold would create?

Sunny

Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7C

Eugene, Oregon, 97401

541- 344- 0509; Fx; 541- 344- 0955

From: twogems@...Date: Wed, 26 Dec 2007 11:15:35 -0800Subject: Unequal pupils

Docs:I have an employee who was out sick (head cold, etc.) for about a week and just returned today. While listening to her description of how she's been feeling, I noticed that her left pupil is dilated compared to the right. She's on antibiotics, but I don't recall ever hearing that those could cause something like that. She hasn't had any head trauma...just a lot of coughing lately. She says she's never had syphilis, so we can hopefully rule our Argyll on pupil. The only thing I can find in my Merck manual is Adie Syndrome, usually affecting women between the ages of 20 and 40 (she's 55), and there is no known cause and no cure.Anybody have any other ideas what might be going on?Lyndon McGill, D.C.Salem, Oregon The best games are on Xbox 360. Click here for a special offer on an Xbox 360 Console. Get it now!

[Guest guest]

Anisocoria is actually a quite common genetic anomoly (20% of US population) which is often not noticed until examined closely when a patient is sick. There was mostly likely an overlooked (or unmentioned) difference in pupillary size before your exam. If s/he is sure this is a new issue, then a complete visual acuity and ophthalmologic evaluation is in order. It is not caused by antimicrobial medications.

W. , DC, MD

Cascades East Family Medicine

Oregon Health & Sciences University

On Dec 26, 2007 11:23 AM, <AboWoman@...> wrote:

I have a patient with genetically different pupil sizes. I remember my fears when she came in following an auto accident. She said that other docs had seen this as well all her life. Once I checked with her PCP, I was satisfied. Was your employee like this prior to the cold? Or did you ever have occasion to examine her pupillary responses? Did she cough a lot? Could there be a vascular (intrathecal pressure induced) cause? Are consensual responses normal in spite of the differing pupil sizes? That's an important finding.

Minga Guerrero DC

In a message dated 12/26/2007 11:16:09 AM Pacific Standard Time, twogems@... writes:

Docs:I have an employee who was out sick (head cold, etc.) for about a week and just returned today. While listening to her description of how she's been feeling, I noticed that her left pupil is dilated compared to the right. She's on antibiotics, but I don't recall ever hearing that those could cause something like that. She hasn't had any head trauma...just a lot of coughing lately. She says she's never had syphilis, so we can hopefully rule our Argyll on pupil. The only thing I can find in my Merck manual is Adie Syndrome, usually affecting women between the ages of 20 and 40 (she's 55), and there is no known cause and no cure.

Anybody have any other ideas what might be going on?Lyndon McGill, D.C.Salem, Oregon

See AOL's top rated recipes and

easy ways to stay in shape for winter.

[Guest guest]

Here in Lake Oswego, we are so politically correct, that we change the scores so that there are no unequal pupils. They are all college bound and our property values continue to rise commensurately!

HAHAHA!

One of the concepts MD’s have used for years (probably due to being the only one in town) is to wait and watch. Many neuro phenomena resolve on their own.

I have a patient at 18 years old who has constantly dilated pupils. She has been seen by optometrists who have seen it before.

She has to be careful in bright sunlight but BOY, can she see in the dark!

Also a good idea to contact some optometrists about your patient.

Keep us posted on what you learn.

Abrahamson, DC

On 12/26/07 11:15 AM, " Lyndon McGill " <twogems@...> wrote:

Docs:

I have an employee who was out sick (head cold, etc.) for about a week

and just returned today. While listening to her description of how she's

been feeling, I noticed that her left pupil is dilated compared to the

right. She's on antibiotics, but I don't recall ever hearing that those

could cause something like that. She hasn't had any head trauma...just a

lot of coughing lately. She says she's never had syphilis, so we can

hopefully rule our Argyll on pupil. The only thing I can find in

my Merck manual is Adie Syndrome, usually affecting women between the

ages of 20 and 40 (she's 55), and there is no known cause and no cure.

Anybody have any other ideas what might be going on?

Lyndon McGill, D.C.

Salem, Oregon

( E. Abrahamson, D.C.)

Chiropractic physician

Lake Oswego Chiropractic Clinic

315 Second Street

Lake Oswego, OR 97034

503-635-6246

Website: http://www.lakeoswegochiro.com

[Guest guest]

Thanks for the info, . She had an opthalmic exam today and they

decided to send her for a cranial CT. I'll keep you posted on the

results.

Lyndon McGill, D.Cl

Salem, Oregon

Abrahamson wrote:

Re: Unequal pupils

Here

in Lake Oswego, we are so politically correct, that we change the

scores so that there are no unequal pupils. They are all college bound

and our property values continue to rise commensurately!

HAHAHA!

One of the concepts MD’s have used for years (probably due to being the

only one in town) is to wait and watch. Many neuro phenomena resolve on

their own.

I have a patient at 18 years old who has constantly dilated pupils. She

has been seen by optometrists who have seen it before.

She has to be careful in bright sunlight but BOY, can she see in the

dark!

Also a good idea to contact some optometrists about your patient.

Keep us posted on what you learn.

Abrahamson, DC

On 12/26/07 11:15 AM, "Lyndon McGill" <twogems@...> wrote:

Docs:

I have an employee who was out sick (head cold, etc.) for about a week

and just returned today. While listening to her description of how

she's

been feeling, I noticed that her left pupil is dilated compared to the

right. She's on antibiotics, but I don't recall ever hearing that those

could cause something like that. She hasn't had any head trauma...just

a

lot of coughing lately. She says she's never had syphilis, so we can

hopefully rule our Argyll on pupil. The only thing I can find in

my Merck manual is Adie Syndrome, usually affecting women between the

ages of 20 and 40 (she's 55), and there is no known cause and no cure.

Anybody have any other ideas what might be going on?

Lyndon McGill, D.C.

Salem, Oregon

( E. Abrahamson, D.C.)

Chiropractic physician

Lake Oswego Chiropractic Clinic

315 Second Street

Lake Oswego, OR 97034

503-635-6246

Website: http://www.lakeoswegochiro.com

[Guest guest]

Ron:

Thanks for the info. Yes, she had her eye exam yesterday, then they

sent her for a CT scan. No results yet.

Lyndon

rongrice01 wrote:

Several years ago my wife had unequal pupils. After her

optometrist

evaluated her, and accused me of striking her, he dismissed the pupil

as nothing to worry about. Several years later and a diagnosis of

Glaucoma she had two major eye surgeries, one for a bleb to equalize

her pressure, and another for a cornea transplant, she is doing quite

well.

Not all optometrists check for interocular pressure. Make sure this is

done right away. Had this been done for my wife, she would have saved

a substantial portion of her eye sight.

I keep telling her she is a perfect candidate for a medical marijuana

license, but she turns it down. Go figure!!!

Anyway, make sure your patient is checked for Glaucoma. It may save

her eye sight.

Grice, DC

Albany, OR