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Eyelogy on Instagram: "Anisocoria worse in bright light = the LARGE pupil is abnormal. When the pupil fails to constrict in light, think parasympathetic dysfunction. Here are the key differentials—and how to separate them clinically: 🔹 Adie’s tonic pupil • Young females • Poor light reaction, better near response (light–near dissociation) • Segmental iris constriction • Constricts with dilute pilocarpine (0.125%) 🔹 Oculomotor (3rd nerve) palsy 🚨 • Dilated pupil + ptosis + EOM restriction • Of
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Argyll Robertson (AR) pupils, They are characterized by small and irregular pupils that have little to no constriction to light but constricts briskly to near targets (light-near dissociation). The affected pupils initially appear small, and are irregular, but as opposed to the tonic pupil do not maintain increased tone to near targets. The pupils are noticeably able to accommodate to near targets, with subsequent normal and brisk redilation to far. The characteristic light-near dissociation of
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