A 63-year-old woman presented to the office due to eye asymmetry that was noticed by her husband. The patient does not complain of any other symptoms. She has a positive medical history of hypertension and diabetes mellitus type 2. Blood pressure is 135/85 mm Hg and pulse is 96/min. Physical examination reveals pupillary asymmetry, the right pupil is 3 mm and the left pupil is 5 mm. The asymmetry increases when the light is dimmed. Which of the following is the most likely location of the lesion?

Question

Quizplus · Accepted Answer

Eductional Objective: Disruption of the ocular parasympathetic or sympathetic pathways leads to pupillary asymmetry ( Anisocoria). This patient's presentation of anisocoria that increased in the dim light, shows that the smaller pupil can not dilate. This indicates a right-sided oculosympathetic pathway injury.

A 63-Year-Old Woman Presented to the Office Due to Eye