Žiak P, Kapitánová K, Halička J
Cesk Slov Oftalmol. 2019 Summer;75(3):145-149. doi: 10.31348/2019/3/5.
Anisocoria is a condition characterized by an unequal size of the eyes' pupils. There is a broad spectrum of aetiological factors including benign and also life- threatening situations. The most important point is the ability to find the anatomical location of the pathology. Understanding to the anatomical, physiological and pharmacological influences helps us to solve the diagnostic challenge. In the article authors present the issue of the anisocoria in the childhood through two case presentations. Causes of an unequal size of the eyes' pupils are in this two cases different. In both of the cases the anisocoria is temporary with spontaneous resolution without any therapy. Diagnostic challenge is well- described with the analysis of important Pilocarpin pharmacological tests. Pharmacological diagnostic tests are a very effective method to differentiate between the pharmacological mydriasis and the mydriasis caused by another factor. Strictly taken patient´s history with targeted questions searching for recent contact with some drugs, plants or medications is crucial. Sometimes it is necessary to consider an unusual diagnosis - benign episodic unilateral mydriasis.
瞳孔不等大是一种以双眼瞳孔大小不等为特征的病症。其病因范围广泛,包括良性情况以及危及生命的情况。最重要的是能够找到病变的解剖位置。了解解剖学、生理学和药理学影响有助于我们应对诊断挑战。在本文中,作者通过两个病例介绍阐述了儿童瞳孔不等大的问题。这两个病例中双眼瞳孔大小不等的原因各不相同。在这两个病例中,瞳孔不等大都是暂时性的,未经任何治疗便自行消退。通过对重要的毛果芸香碱药理学试验的分析,很好地描述了诊断挑战。药理学诊断试验是区分药物性散瞳和由其他因素引起的散瞳的非常有效的方法。严格获取患者病史并针对性询问近期是否接触过某些药物、植物或药剂至关重要。有时有必要考虑一种不寻常的诊断——良性发作性单侧散瞳。