Cesk Slov Oftalmol. 2020 Winter;76(5):232-235. doi: 10.31348/2020/33.
The aim of the work is to approach the examination of the pupil with a focus on anisocoria, its characteristics and approach to the diagnosis of pupillotonia and Adie's syndrome and its clinical evaluation. Pupil function is important not only in neurophthalmological examination but also in general ophthalmological examination. First of all, we need to know how the reflex arc works in order to be able to exclude or confirm whether the parasympathetic or sympathetic is affected. It is also necessary to know the exact characteristics of the pupil, such as size, shape, placement, function and reaction to light and at close range. Only on this basis can we distinguish pathological features. We do not often encounter this diagnosis, but it is necessary to keep it in mind, especially in the field of neurophthalmology but also in general ophthalmology. We also present three cases of pupilotonia and Adie's syndrome, which we diagnosed at the Department of Ophthalmology, Faculty of Medicine, Comenius University, after the patient himself came by emergency admission or was sent directly to ophthalmology clinic. In the discussion, we present various other diagnoses, where the reflex arc may not be affected, but the pathological pupil is caused by intraocular tumors, general systemic diseases and, last but not least, local therapy or alkaloids.
这项工作的目的是关注瞳孔不等大，探讨瞳孔检查，探讨瞳孔对光反射和调节反射的诊断及临床评估。瞳孔功能不仅在神经眼科检查中很重要，在一般眼科检查中也很重要。首先，我们需要了解反射弧的工作原理，以便能够排除或确认副交感神经或交感神经受到影响。还需要了解瞳孔的确切特征，例如大小、形状、位置、功能以及对光和近距离的反应。只有在此基础上，我们才能区分病理性特征。我们并不经常遇到这种诊断，但有必要牢记在心，特别是在神经眼科领域，也在一般眼科领域。我们还介绍了三个瞳孔对光反射和调节反射的病例，这些病例是在科美纽斯大学医学院眼科系诊断的，患者是通过急诊入院或直接转至眼科诊所就诊的。在讨论中，我们还介绍了其他各种诊断，在这些诊断中，反射弧可能不受影响，但病理性瞳孔是由眼内肿瘤、全身系统性疾病引起的，最后但并非最不重要的是，局部治疗或生物碱也会引起瞳孔异常。
