Diagnostic procedures in anisocoria

master's thesis

• Title (croatian): Dijagnostički postupci u anizokoriji
• Author: Steven Golod
• Mentor: Tomislav Vidović (mentor)
• Committee member: Tomislav Jukić (predsjednik povjerenstva)
• Committee member: Miro Kalauz (član povjerenstva)
• Committee member: Tomislav Vidović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Ophthalmology and Optometry); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Ophthalmology

Abstract

This paper is a narrative review of the literature regarding diagnostic procedures in anisocoria. Due to the many technological and pharmacological advances made in modern day medicine, an accurate diagnosis is sine qua non. Patients displaying acute
pupil irregularities are an increased risk for life threating conditions. Workup of acute anisocoria frequently involves costly and/or invasive procedures, which has resulted in much debate over practical guidelines on how to handle abnormal pupillary findings.
Nonetheless, there is a body of evidence suggesting that a thorough eye examination results in better overall patient outcomes. Currently, there is a consensus that a clinically guided history and examination is the first step in establishing a diagnosis. Laboratory studies, imaging studies and other diagnostic procedures depend entirely upon the underlying cause of anisocoria. In the hospital setting, physicians are required to rule out life-threating causes. Conversely, in an outpatient setting an underlying
etiology must be determined. Anisocoria may be the cause of variable patient morbidity thus reinforcing the value of a prompt diagnosis, effective communication and proper follow up in such patients.

Abstract (croatian)

Ovaj rad je narativni pregled literature o dijagnostičkim postupcima u anizokoriji. Zbog napretka do kojeg je došlo u tehologiji i farmakologiji u modernoj medicini, točna dijagnoza je sine qua non. Pacijenti koji pokazuju akutne neispravnosti pupile su u povećanom riziku od po život opasnih stanja. Praktične smjernice o tome kako pregledati pupilu i kako postupiti u abnormalnim nalazima pupila su tema rasprave u literaturi zbog toga što dijagnostika akutne anizokorije često uključuje skupe i/ili invazivne procedure. Međutim, postoji dokaz koji jamči da detaljno ispitivanje rezultira boljim ishodima. Trenutno postoji konsenzus da su klinički vođena povijest bolesti i pregled prvi korak u uspostavljanju dijagnoze. Laboratorijska istraživanja, studije snimanja i ostale dijagnostičke procedure ovise u potpunosti o temeljnom uzroku anizokorije. U bolničkom okruženju, liječnici su potrebni isključiti po život opasna stanja. Obrnuto, u ambulantnom okruženju temeljni uzrok mora biti utvrđen. Anizokorija može biti uzrok različitih stupnjeva morbidnosti pacijenta, čime se pojačava vrijednost brzine dijagnoze, efektivne komunikacije i pravilno praćenje u takvih pacijenata.

• Keywords: anisocoria; pupil; Horner syndrome; tonic pupil; CN III palsy; afferent pupillary defect
• Keywords (croatian): anizokorija; pupila; Hornerov sindrom; tonička zjenica; paraliza trećeg moždanog živca; aferentni pupilarni defekt
• Language: english
• URN:NBN: urn:nbn:hr:105:755935
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-03-29 12:26:51