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Challenging case of unilateral mydriasis
  1. Alexander Stevenson1,
  2. Katie Yoganathan2,
  3. Jonathan Fox2,
  4. David Shackleton1
  1. 1 Accident and Emergency, West Middlesex University Hospital, Isleworth, UK
  2. 2 West Middlesex University Hospital, Isleworth, UK
  1. Correspondence to Dr Alexander Stevenson, Accident and Emergency, West Middlesex University Hospital, Isleworth TW7 6AF, UK; alexstevenson1992{at}

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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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  • Contributors All authors contributed equally.

  • Funding The authors have not given a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.