![]() ![]() The patient had no clinical features of von Hippel-Lindau disease and genetic testing for common mutations ruled out this disorder with 90% certainty. An area of increased signal enhancement in the medulla was noted, but had not changed over a 10-year period. These also excluded tumor recurrence or other gross intracranial pathology as a cause. Irregular pupil cycling can be suggestive of demyelinative optic neuropathy, and this was further ruled out by reviewing the multiple magnetic resonance imaging scans he had regularly after surgery. If you develop unequal pupil sizes of more than 1 mm and do not return to equal size, you may have an eye, brain, blood vessel, or nerve disease or condition. In this case, doctors may suspect third nerve palsy and would do a CT or MRI scan for diagnosis. The patient did not report altered sensation in the nasociliary distribution, deep tendon reflexes were preserved, Venereal Disease Research Laboratory test was negative, and cerebrospinal fluid opening pressure and constituents were also normal. In the light, the pupil that is bigger is usually the abnormal pupil. There was no segmental paresis of the iris sphincter, and both constricted symmetrically to light ( video 1 available online at ) oculomotor function was normal and there was no ptosis. The type of relevant variables include, teacher-pupil ratios, measures of teaching experience (such as years), teacher education, library size, number of computers, audio-visual equipment, number and quality of laboratories as well as information on the ownership of the school19. On examination, the right pupil was approximately 4 mm larger than the left. ![]() ![]() Horner syndrome may be the result of another medical problem, such as a stroke, tumor or spinal cord injury. Typically, signs and symptoms of Horner syndrome include decreased pupil size, a drooping eyelid and decreased sweating on the affected side of the face. The Collaborative Community on Ophthalmic Imaging It is caused by the disruption of a nerve pathway from the brain to the head and neck. ![]()
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