![]() ![]() Is isolated mydriasis likely to be caused by a 3rd nerve paresis?ĩ. What may happen to the size of the pupil over time in the Adie syndrome?Ĩ. What topical drop is used to confirm the presence of Adie pupil syndrome?ħ. What explains the light-near dissociation classically found in Adie tonic pupil syndrome.Ħ. What are the clinical symptoms and signs of Adie tonic pupilĥ. What are two conditions that cause mydriasis via the parasympathetics?Ĥ. How does one test for pharmacologic mydriasis from topical agents?ģ. What are ocular disorders that keep a large pupil from constricting?Ģ. Further studies are needed to reveal the underlying pathophysiology, refine treatment approaches, and assess long-term outcomes.1. This case highlights the importance of reporting such instances to contribute to the understanding of this condition and guide future research endeavors. In the light of a poor visual outcome associated with any surgical intervention, particularly pupiloplasty, due to the anticipated development of sensory-deprived amblyopia, we assume that performing surgical intervention to this case will not be determinantal.Īlthough unilateral corectopia is a rare occurrence, its clinical significance should not be ignored. We hypothesize that the surgical methods, including Nd:YAG laser, might have been helpful in our case if a radiating membrane or the visual aperture were noted, and procedure had been performed almost immediately after birth. The authors emphasized that provided the physician is skillful, with a proper laser energy is used, no significant sequalae will occur. ![]() supported the use of Nd:YAG laser for managing congenital persistent pupillary membrane. All children have had favorable visual outcomes. The third was treated with medical mydriasis. The treatment plan included an Nd:YAG laser for one baby, and incisional surgery for another one. described three patients with corectopia. ![]() Limited reports suggested satisfactory results following restricted interventions. However, our case did not demonstrate any other manifestations suggestive of syndromes. These hypotheses, while theoretical, offer perceptions into possible mechanisms that necessitate further investigation.įew cases were reported to be associated with syndromes like ELeP, persistent pupillary membrane, Axenfeld-Reiger anomaly, Rieger syndrome, or Myhre syndrome. Some have suggested genetic defects leading to abnormal membranes formation arranged in radiating folds dragging the pupil, remnants of anterior tunica vasculosa lentis membrane, and the potential of fetal iritis. While the exact prevalence remains uncertain due to the scarcity of cases, its uniqueness and clinical implications cannot be understated. * Pupil was observed to be located at the 6 o'clock position with no visible aperture with no fibrous membrane noted. * The left eye only demonstrated the ability to perceive hand movements * Amblyopia was not present in any of the patients The third was treated with medical mydriasis.Īll four children have had favorable visual outcomes to date. Two who developed shallow anterior chambers were treated surgically, one with an Nd:YAG laser and the other with incisional surgery. * Isolated unilateral corectopia in 4 infants, resulting from a white band that extended from the pupil margin to insert in a circumferential condensation of tissue on the endothelial surface of the peripheral cornea that superficially resembled an incomplete posterior embryotoxon * His visual acuity, visual fields, and optic fundi were normal * The left eye showed a small eccentrically placed pupil with reduced papillary diameter * The visual acuity was 6/24 in the right eye and 2/60 in the left * Reactions to light were brisk except from the medial side The visual acuity in the right eye could be improved to 6/6-2. The right eye needed - 1-75 D sph.,- 2.5 D cyl., axis 110°. * The left eye pupil was displaced medially and elliptical in shape * A pupil opening was present with normal red reflex and limited view of the ocular fundus * Fibrous band extending from the pupil margin to the endothelial surface of the peripheral supero-nasal cornea The eye settled well without complications. * Occlusion therapy was commenced the eye became visually unresponsive * Central pupil was created by small multiple iris sphincter incisions * Unilateral (right) misshapen eccentric pupil ![]()
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