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An approach to anisocoria

Gross, Jordan R.; McClelland, Collin M.; Lee, Michael S.

Current Opinion in Ophthalmology: November 2016 - Volume 27 - Issue 6 - p 486–492
doi: 10.1097/ICU.0000000000000316
NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari

Purpose of review Anisocoria is a finding seen on a daily basis in nearly every eye clinic. Although often benign, it can also represent the sole sign of a life-threatening disease making an up-to-date understanding of pathophysiology and diagnosis essential for anyone practicing medicine.

Recent findings Many aspects of the traditional approach to anisocoria still hold true today, but advancements in imaging technology and changing trends in pharmacologic diagnosis and localization have led many to rethink that approach. In addition, the differential diagnosis for anisocoria continuously expands with identification and improved understanding of causal disease processes.

Summary The present article discusses an approach to the classic anisocoria diagnostic algorithm modified by current knowledge from the most recent literature.

Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, USA

Correspondence to Michael S. Lee, MD, 420 Delaware St SE, MMC 493, Minneapolis, MN 55455, USA. Tel: +1 612 625 3553; Fax: +1 612 626 3119; e-mail:

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