HTHSCI 2F03 Lecture Notes - Lecture 16: Marcus Gunn Pupil, Argyll Robertson Pupil, Superior Tarsal Muscle

• School: McMaster University
• Department: Health Sciences
• Course: HTHSCI 2F03
• Professor: Bruce Wainman

Document Summary

Usually 2o to spreading facial infection via the ophthalmic veins. No direct response but intact consensual response. Cannot initiate consensual response in contralateral eye. Dilatation on moving light from normal to abnormal eye. Dilated pupil does not react to light. The pupil is often spared in a vascular lesion (e. g. dm) as pupillary fibres run in the periphery. Young woman c sudden blurring of near vision. Dilated pupil has no response to light and sluggish response to accommodation. Iris shows spontaneous wormy movements on slit-lamp examination. Tonic pupil + absent knee/ankle jerks + bp. Pc: attacks of acute visual loss, sequential in each eye ataxia and cardiac defects. Blocked drainage of aqueous from anterior chamber via the canal of schlemm. Pupil dilatation (e. g. @ night) worsens the blockage. Prodrome: rainbow haloes around lights at night-time. Pilocarpine 2-4% drops stat: miosis opens blockage. Topical -b (e. g. timolol): aqueous formation. Acetazolamide 500mg iv stat: aqueous formation.