Approach to anisocoria in the emergency department

Anisocoria describes asymmetric pupillary diameter, which can result from traumatic, pharmacologic, inflamma-tory, or ischemic effects on the eye. In many cases, anisocoria represents a normal physiologic variant. Morbidity associated with anisocoria is directly related to the inciting cause and can vary from benign to life-threatening. A thorough understanding by emergency physicians of normal ocular neuroanatomy, and of common causes of pathologic anisocoria, including medication-induced anisocoria, can facilitate appropriate resource utilization and timely subspecialty consultation, and can help prevent irreversible ocular injury and patient morbidity. We describe a patient who presented to the emergency department with acute onset of blurry vision with anisocoria. & COPY; 2023 Elsevier Inc. All rights reserved.

Automated summary

Anisocoria is an asymmetry in the size of the pupils, often caused by trauma, medication, inflammation, or lack of blood supply to the eye. Understanding the normal ocular neuroanatomy and common causes of pathological anisocoria is important for emergency physicians to provide appropriate medical care and prevent irreversible eye damage. This article describes a case of a patient presenting to the emergency department with sudden blurry vision and anisocoria.