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MydriasisAka: Pupil Dilation, Pupil Dilitation

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  1. Normal Response
    1. Sympathetic stimulation
    2. Dark lighting conditions
  2. Causes: Bilateral Dilated Pupil
    1. Mnemonic: AAAS
      1. Anticholinergic Toxicity or Atropine
      2. Antihistamines
      3. Antidepressants (Tricyclic Antidepressants)
      4. Sympathomimetics (Cocaine, Amphetamines)
    2. Carbon Monoxide Poisoning
  3. Causes: Unilateral Dilated pupil
    1. See Also Anisocoria
    2. Comatose patient
      1. Indicative of brain stem herniation
    3. Alert patient
      1. Not due to increased Intracranial Pressure
      2. Acute Glaucoma
      3. Mydriatic drug (e.g. Atropine)
      4. Cranial Nerve III paralysis
        1. Posterior Communicating Artery aneurysm
  4. Causes: Dilated pupil does not constrict with Pilocarpine
    1. Local Eye Trauma
    2. Topical anticholinergic agent present in eye

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