Pigment Dispersion Syndrome Mimicking Congenital Horner Syndrome

Background

Anisocoria has several etiologies [1]. It can represent a simple physiologic asymmetry of pupil size. Anisocoria can also be the result of injury to autonomic impulses (parasympathetic or sympathetic), which govern the iris sphincter and dilator muscles. Anisocoria can also develop from iris abnormalities, which mechanically limit pupillary shape, size, and movement. When subtle, such iris conditions may be overlooked and confused for more serious neurologic conditions causing anisocoria.

• References

• 1 Kawasaki A. Diagnostic approach to pupillary abnormalities. Continuum 2014; 20: 1008-1022
• 2 Lam BL, Thompson HS, Corbett JJ. The prevalence of simple anisocoria. Am J Ophthalmol 1987; 104: 69-73
• 3 Koc F, Kavuncu S, Kansu T. The sensitivity and specificity of 0.5 % apraclonidine in the diagnosis of oculosympathetic paresis. Br J Ophthalmol 2005; 89: 1442-1444
• 4 Ramsay DA. Dilute solutions of phenylephrine and pilocarpine in the diagnosis of disordered autonomic innervation of the iris. Observations in normal subjects, and in the syndromes of Horner and Holmes-Adie. J Neurol Sci 1986; 73: 125-134
• 5 Scheie HG, Cameron JD. Pigment dispersion syndrome: a clinical study. Br J Ophthalmol 1981; 65: 264-269
• 6 Siddiqui Y, Ten Hulzen RD, Cameron JD. et al. What is the risk of developing pigmentary glaucoma from pigment dispersion syndrome?. Am J Ophthalmol 2003; 135: 794-799
• 7 Doyle JW, Hansen JE, Smith MF. et al. Use of Scheimpflug photography to study iris configuration in patients with pigment dispersion syndrome and pigmentary glaucoma. J Glaucoma 1995; 4: 398-405
• 8 Lord FD, Pathanapitoon K, Mikelberg FS. Keratometry and axial length in pigment dispersion syndrome: a descriptive case-control study. J Glaucoma 2001; 10: 383-385
• 9 McDermott JA, Ritch R, McDermott J. Familial occurrence of pigmentary dispersion syndrome. Invest Ophthalmol Vis Sci 1987; 28: 136
• 10 Stankovic I. A contribution to the knowledge of the heredity of pigment glaucoma. Klin Monbl Augenheilkd Augenarztl Fortbild 1961; 139: 165-174