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| {{Infobox_Disease |
| | #REDIRECT [[Miosis]] |
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| Under control of the parasympathetic system, '''pupillary constriction''' is an act of the iris constrictor muscle. The abnormal pupil may appear smaller if parasympathetic action goes unopposed. The presence of pupillary constriction should prompt an immediate evaluation for acute [[Horner's syndrome]].
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| == Differential diagnosis of causes of pupillary constriction in alphabetical order==
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| In alphabetical order: <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
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| *[[Adie's pupil]] (long standing)
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| *[[Argyll Robertson Pupils]]
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| *[[Anisocoria]]
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| *[[Coma]]
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| *[[Horner's Syndrome]]
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| *[[Iritis]]
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| *Posterior iris synechiae
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| *Systemic [[opioid]]s
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| *Systemic [[cholinergic]]s
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| *Tertiary [[Syphillis]]
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| *Topical [[cholinergic]]s
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| == Diagnosis ==
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| === History and Symptoms ===
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| *Specific medicinal and surgical history
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| :*attention to neurologic, opthalmologic and otolaryngologic
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| ==== Eyes ====
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| *Pupil size in light and dark
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| *Pupil response to light and convergence
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| *lid position
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| === Laboratory Findings ===
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| *Labs include
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| :*Rapid plasma reagin
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| :*VDRL
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| :*FTA-ABS
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| === MRI and CT ===
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| *Chest CT if Horner's syndrome is found & to rule out apical lung mass
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| *MRI of head and neck if necessary
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| === Other Imaging Findings ===
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| *Carotid Doppler
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| *Carotid Angiogram
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| == Treatment ==
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| === Acute Pharmacotherapies ===
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| *Administer high dose IV penicillin for syphillis
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| == Primary Prevention ==
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| *Remove problem causing medications
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| {{SIB}}
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| [[Category:Signs and symptoms]]
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| [[Category:Physical examination]]
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| [[Category:Opthalmology]]
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| [[Category:Neurology]]
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| [[Category:Emergency medicine]]
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