Traumatic mydriasis
Background
- Pupillary dilation due to blunt eye trauma
- Pupil is poorly reactive to light in both direct and consensual light exposure
- Occurs due to small tears in the ciliary muscles
- May be transient or permanent
- No specific ED management, but requires ophthalmology follow up
- Diagnosis of exclusion!
Clinical Features
Differential Diagnosis
- Physiological Aniscoria
- Intracranial Injury
- Congenital Eye Defects
- Drugs and Toxins
- Third Nerve Palsy
- Pharmacologic Mydriasis
Evaluation
- History of Trauma
- Check use of topical medications
- Exposure to toxin and drugs
- Evaluate ocular and neurological symptoms/signs
- Examine pupils in light and dark