Document Detail


Unilateral mydriasis due to hemorrhoidal ointment.
MedLine Citation:
PMID:  19596177     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background: The finding of a unilaterally dilatated pupil in a patient who is otherwise alert and unimpaired can pose an interesting diagnostic problem. Algorithms have outlined the approach to evaluating anisocoria, but do not stress the importance of toxic exposures. Case Report: A patient with a history of depression and chronic headaches was referred to the emergency department from an ophthalmologist's clinic with the findings of asymmetrically dilatated pupils and blurred vision. Detailed history revealed that for several weeks before the onset of symptoms, the patient applied to her eyelids hemorrhoidal ointment that contained an active ingredient known to produce mydriasis. Conclusion: In the absence of neurologic deficits, clinical history should search for a toxic or pharmacologic etiology of abnormal mydriasis. A detailed physical examination and bedside diagnostic maneuvers can help distinguish benign causes of an abnormally dilatated pupil from more serious causes relating to central nervous system lesions, potentially sparing the patient from unnecessary neuroimaging.
Authors:
Matej Polomský; Janet Smereck
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Publication Detail:
Type:  Journal Article     Date:  2009-07-12
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  43     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e11-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Department of Internal Medicine, Georgetown University Hospital, Washington, DC.
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