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A 40-year-old female gardener presented with a 1-day history of a dilated left pupil (figure 1). She denied headaches, vomiting, double vision, eye pain or discharge. There was no history of topical eye-drops or trauma. On examination, her left pupil was 8 mm compared with her right pupil at 3 mm. The left pupil was non-reactive to direct and consensual light responses, and accommodation reflex was impaired. Her right pupillary reflexes were intact. There was …
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