An elementary cause of anisocoria in intensive care unit

Abstract

Sudden onset anisocoria in critical care setting can be ominous signifying various neurological conditions like uncal herniation due to intracerebral hemorrhage, hypertension or tumour, Adie’s tonic pupil, glaucoma or iritis. But about 20% cases can be congenital1 or pharmacological. This awareness can prevent unnecessary consultation and neuro-imaging, hence reduce hospital charges. Here, we present a case of unequal papillary size following ipratropium nebulisation in a tertiary care hospital.