المشاركة الأصلية كتبت بواسطة د.محمود صلاح
شكرا جدا لرد حضرتك ولمجهودك
The pupils I sow in this child was nearly as narrow as the picture in your signature , I will be of great thanks if you put a picture of a pinpoint pupil for me
also I found in internet " nelson ....book of pediatrics " What's called " paradoxical pupilary reaction " in which some child react to dark by miosis then slowly re dilate , is this normal or stand behind a pathology ?
many thanks
Dear Dr. Mahmoud
Sorry for being late in my answer to your question, but I was very busy
Regarding "paradoxical pupillary response" it's almost always of pathological nature
It's either constriction of the pupils in the dark followed by slow dilatation & this almost always indicates retinal or optic nerve pathology (e.g. night blindness or optic atrophy) & it's considered a sign indicating their presence even if not clearly seen, & the cause of this phenomenon is not yet clear. On the other hand paradoxical pupillary response could be dilatation )instead of miosis) to light exposure & this usually happens when there is a media problem (eg cataract) or retinal problem in one eye & can be elicited by swinging the light between the two eyes, here when we shine light to normal eye its pupil contracts (direct light reflex) & the other eyes pupil too (consensual light reflex) but when you remove the light & shine it on the other eye (the pathological one) the 1st eye responds to removal of light stimulus by dilatation & since the other eye is affected so its response to light perception is impaired so it responds more to the effect of the 1st eye & dilates instead of miosis. so any way, either type of the paradoxical lifght reflect, it's pathological
As for pin point pupil it's usuall small then 2 mm & usually irresponsive or sluggish to dilatation
The pupil in my signature is 2 mm wide which is narrow (miotic) but not pinpoint
sincerely
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