Physiologic anisocoria

Physiologic anisocoria

• • Examination shows right pupil is smaller than the left in the light.
• • Degree of anisocoria is about the same in the dark. A Horner's pupil will result in anisocoria that is greater in the dark than in the light (abnormal pupil is the smaller one). An Adie's pupil will result in anisocoria that is greater in the light than in the dark (abnormal pupil is the larger one).
• • Cocaine test results in both pupils dilating. A true Horner's pupil does not dilate with cocaine. Cocaine blocks the reuptake of norepinephrine.

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