Anisocoria Differential Diagnosis Flow Diagram Medical Algorithm

Are you evaluating a patient with unequal pupils?

Yes

Difference in pupil diameter is greater

Is damage to the iris seen on slit lamp examination?

Yes

Are deep tendon reflexes decreased?

Yes

Is there a segmental palsy to the iris?

Yes

Does the smaller pupil show a poor light reflex?

Yes

Is the larger pupil constrict to a dilute (< 0.125%) pilocarpine solution?

Yes

Does the larger pupil constrict after 1% pilocarpine drops?

Yes

Do both pupils dilate equally to 1% hdyroxy-amphetamine drops?

Yes

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Data complete?

Evaluation appropriate?

C/w local iris damage

C/w Holmes-Adie syndrome?

C/w third nerve palsy

C/w atropinic mydriasis

C/w simple anisocoria

C/w Horner's syndrome, central or preganglionic type

C/w Horner's syndrome, postganglionic type

C/w unspecified disorder

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Evaluation

Results

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Interpretation and Description

References

Specialty

Objective

ICD-10

Algorithm of Czarnecki et al for Evaluating a Patient with Unequal Pupils

Purpose: To evaluate a patient with unequal pupils using the algorithm of Czarnecki et al.

Evaluation

Results

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Interpretation and Description

References

Specialty

Objective

ICD-10