Deviated Pupil???

[melangel16]

Okay - just had a pt who was very confused (new), slurred speech etc. Determined prob a bleed - anyways he presented with his right pupil deviated to the right - not the entire eye - just the pupil. The rest of the eye functioned properly and pupils were equal (right one no response though to light) and according to his wife his eye was not like that before.

Just wondering if anyone has ever seen this or heard of this before - it's got me confused. :?

[traumaman5150]

Okay - just had a pt who was very confused (new), slurred speech etc. Determined prob a bleed - anyways he presented with his right pupil deviated to the right - not the entire eye - just the pupil. The rest of the eye functioned properly and pupils were equal (right one no response though to light) and according to his wife his eye was not like that before.

Just wondering if anyone has ever seen this or heard of this before - it's got me confused. :?

I went to a seminar a couple of years ago where the optic lense was deviated 2-5 mm left or right up or down was a symptom for Marfan syndrom and Aortic Dissertion? Any cardiac History? www.marfan.org

[Ridryder 911]

Common physical finding in TBI, and herniations with pressure on the optic nerve, and ICP. Usually, it is both pupils not unilateral. However; about anything can go.

As well other neuro findings, we definitely need to increase neuro assessment and understanding for the EMT education.

R/r 911

[iMac]

Im sorry I think I might be an idiot...so you would have the actual pupil deviate and move from the centre of the eye? Wouldnt it change the shape of the eye? Im having a hard time trying to understand that.

[Ridryder 911]

It is not the "pupil" that changes places rather the way the pupil is pointed to. I agree the statement was confusing and its description would be anatomically impossible.

R/r 911

[melangel16]

I know it sounds funny - but the pupil was shifted towards the right side of the eye (not the middle) and the same size (3) as the other pupil - the rest of the eye/iris etc was as per normal (no changes).

[sledogg1]

Defintly nuro, any hx of shunts, spinal, cateracts...........it pressure on a cranial nerve. Was stroke test neg.

[Laura Anne]

Long shot, but perhaps the patient had a nevus that was never noticed prior to the medical event at hand?

[afib]

ok thats a new one but as one previous person stated, and cataract surgery, facial trauma, or lazy eye surgery.???? nothing surprises me and expect to see weird shit, definitly sounds like something to as a optomitrist or opthamologist see if you can get some sorry for the pun insight to the situation.

[dahlio]

Is this medical or trauma related? (asked as a general question, not looking for a specific answer) Any recent accidents? (this one is specific )