PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Pupil Disorders”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources

Disordered pupil reactivity in Parkinson's disease.

Different varieties of pupillary abnormalities have been described in Parkinson's disease but it is not clear if this is due to the disease itself or to the pharmacological treatment. In this study, pupil reactivity to various stimuli (dark/light adaptation, light reflex, near vision reaction and electrical sural stimulation) was investigated in 23 de novo parkinsonian patients (not on drugs) to assess pupillary abnormalities and investigate their pathophysiological mechanisms. Parkinsonian patients exhibited larger pupil diameter after light adaptation, as well as a reduced amplitude of contraction and a prolonged contraction time at light reflex. The data obtained confirmed the existence in Parkinson's disease of a pupillary imbalance mainly involving the parasympathetic system.

Adaptation, Ocular↗

Physiology, assessment, and disorders of the pupil.

Proper examination of the pupil provides an objective measure of the integrity of the pregeniculate afferent visual pathway and allows assessment of sympathetic and parasympathetic innervation to the eye. Infrared videography and pupillography are increasingly used to study the dynamic behavior of the pupil in common disorders, such as Horner's syndrome and tonic pupil.

Humans↗

Influence of pupil size, anisocoria, and ambient light on pilocarpine miosis. Implications for supersensitivity testing.

BACKGROUND: This study determines how pupil size, anisocoria, and ambient light influence miotic responses to dilute pilocarpine. The aim is to establish whether mechanical properties of the iris affect miotic behavior using a cholinergic agonist and, if so, to define a more specific clinical definition of supersensitivity testing for suspected tonic pupil disorders. METHODS: The right pupil of 42 normal subjects was first dilated with phenylephrine to create an experimental anisocoria. Then, pilocarpine 0.1% was placed in both eyes. Net constriction of the larger right pupil was determined by subtracting the amount of pilocarpine-induced constriction of the control left pupil from the amount of pilocarpine-induced constriction of the experimental right pupil. Pupil diameters were measured in room light and darkness. RESULTS: In only a few subjects, the larger right pupil became smaller than the left pupil after pilocarpine administration. Net constriction of the right pupil was greater when determined in room light than in darkness. The amount of net constriction of the right pupil showed good correlation with the degree of baseline anisocoria when evaluated in room light, but not so in darkness. CONCLUSION: Pupil size, degree of anisocoria, and light conditions influence the amount of pilocarpine-induced change in anisocoria. If a patient's larger pupil becomes the smaller pupil in darkness after dilute pilocarpine is applied to both eyes, then it is likely that such a response occurred independent of mechanical properties of the iris, and likely represents a supersensitive response. Ophthalmology.

Adolescent↗

The Argyll Robertson pupil.

The Argyll Robertson (AR) pupil has been defined as a pupil that is small and constricts poorly to direct light but briskly when a target within reading distance is viewed ("light-near dissociation"). Most descriptions of the AR pupil do not mention segmental iris sphincter constriction, or slow, sustained constriction with a near vision effort. Such features are considered typical of the light-near dissociation of Adie syndrome and of neuropathic tonic pupils, where damage to the ciliary ganglion or ciliary nerves is believed to be the mechanism. Because the AR pupil lacks these features, it has been attributed to a dorsal midbrain lesion that interrupts the pupillary light reflex pathway but spares the more ventral pupillary near reflex pathway. However, lesions in this region have not been reliably demonstrated in syphilis. Resolving the issue about the location of the syphilitic lesion that produces the AR pupil will depend on careful examination of patients with techniques designed to disclose segmental palsy of the iris. If segmental iris sphincter palsy is found and the light-near dissociation has tonic features, one must conclude that the mechanism of the pupil disorder is a ciliary (peripheral) rather than a midbrain (central) denervation. Until better evidence settles the localization of the AR pupil, it is appropriate to screen patients with bilateral tonic pupils for syphilis.

Humans↗

The pupil and its disorders.

Pertinent information concerning the pupil is provided for the practicing and aspiring neurologist, including anatomy and physiology of the normal pupil, a discussion of pupillary disorders, and unusual pupillary abnormalities.

Adie Syndrome↗

[Optic neuropathies and peripheral oculomotor disorders in patients with AIDS].

In patients with the acquired immunodeficiency syndrome (AIDS) there is an 8% incidence of neuro-ophthalmological changes. The commonest of these neuro-ophthalmological changes are: 1) Cranial nerve pareses 2) Optic neuropathy and 3) Pupil disorders. The cranial nerve pareses are usually combined, rather than single, and are due to intraparenchymatous lesions (toxoplasmosis or lymphoma) or to meningitis (tuberculous or lymphoma). The optic nerve changes tend to be papillitis due to CMV or optic neuropathy due to syphilis or to cryptococcal meningitis. Among the pupil changes, Bernard-Horner syndromes due to sympathetic involvement, Argyll-Robertson pupils due to mesencephalic tectal lesions and mydriasis associated with the common oculo-motor nerve have been described.

Acquired Immunodeficiency Syndrome↗

[The pseudoexfoliative syndrome and its significance in cataract surgery].

OBJECTIVE: To find out factors or combinations of factors leading to increased occurrence of complications in operation on cataract in patients with pseudoexfoliative syndrome. SETTING: Eye Clinic SPAM, Bratislava. METHODS: Prospective non-randomized study in 2916 patient of different age and sex, followed for 6 months after the operation on cataract. The standardized operation protocol was used. Complications were followed during and after the operation in view of released supporting apparatus, loss of vitreous body, uveal reaction and the occurrence of secondary cataract. RESULTS: PEX occurred in 2.98% of the surgically treated patients of the group, most often in the age group of 75-84 years. The occurrence was independent of sex, but increased with age. There was not any relation between age and the type of cataract, incidence of complications, inflammatory reaction, and width of pupil, endo-telepathy and glaucoma. The incidence of per-operation complications in 13.7% is directly related to the syndrome, a narrow pupil, disorder of supporting (suspension) apparatus and worse visual acuity. From the 34 patients with PEX and increased inflammatory reaction, 22.9% suffered from secondary cataract after 6 months. A relationship between width of the pupil, time factor, hardness of cornea and the incidence of inflammatory reaction was demonstrated in 24.1%. CONCLUSION: PEX itself is the source of most severe complications in operation on cataract. The patients should be in dispensary care and operated on in time by an experience surgeon.

Aged↗

Disorders of the pupil.

The pupil is one objective marker of vision and autonomic pathways. A good understanding of its anatomy and careful examination techniques are the essential tools for proper clinical diagnosis of pupillary disorders.

Diagnostic Techniques, Ophthalmological↗

Evaluation of an exercise-based treatment for children with reading difficulties.

An evaluation is reported of an exercise-based approach to remediation of dyslexia-related disorders. Pupils in three years of a Warwickshire junior school were screened for risk of literacy difficulty using the Dyslexia Screening Test (DST). The 35 children scoring 0.4 or over on the DST were divided randomly into two groups matched for age and DST score. One quarter of the participants had an existing diagnosis of dyslexia, dyspraxia or ADHD. Both groups received the same treatment at school but the intervention group used the DDAT exercise programme daily at home. Performance on the DST and specialist cerebellar/vestibular and eye movement tests were assessed initially and after six months. Cerebellar/vestibular signs were substantially alleviated following the exercise treatment whereas there were no significant changes for the control group. Even after allowing for the passage of time, there were significant improvements for the intervention group in postural stability, dexterity, phonological skill, and (one-tailed) for naming fluency and semantic fluency. Reading fluency showed a highly significant improvement for the intervention group, and nonsense passage reading was also improved significantly. Significantly greater improvements for the intervention group than the control group occurred for dexterity, reading, verbal fluency and semantic fluency. Substantial and significant improvements (compared with those in the previous year) also occurred for the exercise group on national standardized tests of reading, writing and comprehension. It is concluded that, in addition to its direct effects on balance, dexterity and eye movement control, the benefits of the DDAT exercise treatment transferred significantly to cognitive skills underlying literacy, to the reading process, and to standardized national literacy attainment tests.

Apraxias↗

Pierson syndrome with numerous dilated tubules masquerading as autosomal recessive polycystic kidney disease: a case report.

Pierson syndrome, characterized by congenital nephrotic syndrome, ocular abnormalities, and neurological defects, is caused by biallelic pathogenic variants in LAMB2. LAMB2 encodes laminin β2, a key component of basement membranes that is predominantly expressed in the glomeruli, eyes, and neuromuscular junctions. The renal histopathology of Pierson syndrome typically shows diffuse mesangial sclerosis (DMS), with occasional tubulointerstitial atrophy and fibrosis. We report a case of Pierson syndrome characterized by DMS and prominent tubular dilatation. A fetal ultrasound at 23 weeks of gestation revealed hyperechoic kidneys, which gradually enlarged, accompanied by the onset of anhydramnios from 31 weeks. The patient was delivered at 39 weeks of gestation, weighing 3,132 g, without placentomegaly. Postnatal respiratory failure due to pulmonary hypoplasia required extracorporeal membrane oxygenation, and hemodialysis was initiated for anuria. Left nephrectomy was performed on day 8 of life, revealing replacement of the renal parenchyma by numerous irregularly dilated tubules with eosinophilic casts. The right kidney reached maximal enlargement by 1 month of age and subsequently began to shrink. Ocular findings included bilateral microcoria and cataracts. Whole-exome sequencing identified compound heterozygous truncating variants in LAMB2 (p.Gln1507Ter and p.Gln1622Ter). This case highlights the need to consider Pierson syndrome in the differential diagnosis of prenatally detected hyperechoic and enlarged kidneys, in addition to polycystic kidney disease.

Female↗