BACKGROUND: Thoracoscopic T2 sympathicotomy had been performed as a simple and effective method in treating palmar hyperhidrosis, however, this method had the complications of compensatory hyperhidrosis and facial anhidrosis. Therefore, a more limited and modified methods for T2 sympathicotomies were introduced and comparative analysis of the modified upper and lower T2 sympathicotomy were made in the treatment of palmar hyperhidrosis. MATERIAL AND METHOD: From January 1997 to December 1998, 41 patients with palmar hyperhidrosis had been treated by modified T2 sympathicotomy at the Kon-Kuk University Seoul Hospital. Twenty-four patients underwent a modified upper T2 sympathicotomy(Group A), and seventeen patients underwent a modified lower sympathicotomy(Group B). A comparison between groups A and B were made according to the medical records and interview results. RESULT: All patients showed symptomatic improvements after the operation. The anisocoria, facial anhidrosis and dissatisfaction for compensatory hyperhidrosis were more common in Group A and the individual satisfaction for the operations were higher in Group B. CONCLUSION: The modified lower T2 sympathicotomy might be a more effective and less complicated method than the modified upper T2 sympathicotomy.
Anisocoria ; Humans ; Hyperhidrosis* ; Hypohidrosis ; Medical Records ; Seoul

In an attempt to know the nature of the pupils in neonates, the authors studied the pupil diameter and net miosis to the light stimulation of 70 neonates ranging from 27.3 weeks to 42.0 weeks of gestational age. The mean corneal diameter was 9.3mm. The mean pupil diameters of awakening infants (200 1ux) and in bright light stimulation were 3.1mm and 2.1mm respectively. All the cases had the response to light stimulation and the mean net miosis was 1.0mm. Anisocoria of 0.5mm to 1.0mm was detected in 11 infants (16%). Thus it may be warranted that the careful investigation to search for neurologic abnormalities is necessary if the pupil size of the neonate is more than 2 standard deviation from the mean (smaller than 1.7mm or larger than 4.5mm in dim illummation), or if their pupils do not respond to light challenge.
Anisocoria ; Gestational Age ; Humans ; Infant ; Infant, Newborn* ; Miosis ; Pupil*

In an attempt to know the nature of the pupils in neonates, the authors studied the pupil diameter and net miosis to the light stimulation of 70 neonates ranging from 27.3 weeks to 42.0 weeks of gestational age. The mean corneal diameter was 9.3mm. The mean pupil diameters of awakening infants (200 1ux) and in bright light stimulation were 3.1mm and 2.1mm respectively. All the cases had the response to light stimulation and the mean net miosis was 1.0mm. Anisocoria of 0.5mm to 1.0mm was detected in 11 infants (16%). Thus it may be warranted that the careful investigation to search for neurologic abnormalities is necessary if the pupil size of the neonate is more than 2 standard deviation from the mean (smaller than 1.7mm or larger than 4.5mm in dim illummation), or if their pupils do not respond to light challenge.
Anisocoria ; Gestational Age ; Humans ; Infant ; Infant, Newborn* ; Miosis ; Pupil*

Recently refractive corneal surgery has been increasing and intraocular lens implantation is a routine procedure during cataract surgery. Many people have various activities in the evening such as night driving, thus it may be very important measuring the pupil size in the dark in determining the size of the optical zone. We measured pupil size of sixty normal adult candidates in darkness of 0, 20, 60, 100 lux and also in the bright illumination of 200 lux for comparison using near lens camera and slide film. The pupils became larger with younger age and increased darkness. Pupil Size(log mm) = 4.57 - 0.0388 X Age(year) - 0.005 X Luminance(lux). The average pupil size of all age groups were 7.0mm, 6.56mm, 5.97mm, 5.4mm sequencially in darkness and 4.77mm in brightness(200 lux). The average pupil size of 20~30 year old group who are socially active even at night was 7.18mm and 8.4mm in maximum. This has significant meaning clinically. Additionally the size of pupil became larger with increased corneal diameter and the amount of anisocoria tended to be greater with the increase of the darkness.
Adult* ; Anisocoria ; Cataract ; Darkness ; Humans ; Lens Implantation, Intraocular ; Lighting ; Pupil*

Transient anisocoria is rare during blowout fracture reconstruction. We report a case of transient anisocoria occurring during medial blowout fracture reconstruction and review the relevant literature. A 54-year-old woman was struck in the face and was admitted for a medial blowout fracture of the left eye. During the operation, persistent bleeding occurred. To control this bleeding, a 1% lidocaine solution with 1:200,000 epinephrine was applied to the orbital wall with cotton pledgets. In total, 40 mL of local anesthetic was used for the duration of the operation. After approximately three hours of the surgery, the ipsilateral pupil was observed to be dilated, with sluggish response to light. By 3 hours after the operation, the mydriasis had resolved with normal light reflex. In conclusion, neurological and ophthalmologic evaluation must be performed prior to blowout fracture surgery. Preoperative ophthalmic evaluation is simple and essential in ruling out any preexisting neurologic condition. Moreover, surgeons must be aware of the fact that excessive injection of lidocaine with epinephrine for hemostasis during orbital wall surgery can result in intraoperative anisocoria. Anisocoria-related situations must be addressed in a proficient manner through sufficient understanding of the mechanism controlling the pupillary response to various stimuli.
Anisocoria* ; Epinephrine ; Female ; Hemorrhage ; Hemostasis ; Humans ; Lidocaine ; Middle Aged ; Mydriasis ; Orbit ; Pupil ; Reflex ; Surgeons

PURPOSE: To report a case of iatrogenic Horner's syndrome after video-thoracoscopic surgery for primary pneumothorax. CASE SUMMARY: An 18-year-old man with ptosis in the right eye was referred to our clinic. The patient had undergone wedge resection via video-thoracoscopic surgery for primary pneumothorax three weeks previously. On ocular examination, the palpebral fissure width was 7 mm in the right lid and 8 mm in the left lid, the marginal reflex distance 1 (MRD 1) was 2 mm in the right lid and 3 mm in the left lid, and the bilateral levator muscle function was good. Anisocoria was present, and pupil size in a dark room was 2.5 mm in the right eye and 4 mm in the left eye. The patient complained of facial anhidrosis on the right side of the face. CONCLUSIONS: Although iatrogenic Horner's syndrome is rare complication of video-thoracoscopic surgery for primary pneumothorax, diagnosis after surgery of the thoracic cavity should be made carefully.
Adolescent ; Anisocoria ; Eye ; Horner Syndrome ; Humans ; Hypohidrosis ; Muscles ; Pneumothorax ; Pupil ; Reflex ; Thoracic Cavity

BACKGROUND & OBJECTIVE: The purpose of this study is to prove the characteristics of refractive error and visual acuity about hansen patients and old people. To compare the pupil and ocular function was to investigate the characteristics of the eye of the hansen patients. METHODS: Subjects were intended for the elderly over 60 years old 85 years old or younger both hansen patients in Wonju(n=29) and old people in Yangpyeong(n=29). Auto refraction(Topcon KR-7000) to objective refraction was conducted after the subjective refraction. Pupil size at normal illumination and light reflex, response velocity and the reaction states about light reflex were measured and Color vision test were. Writing questionnaires and analyzed the subjective symptoms about two groups. Spss ver.18.0 was used for statistics analysis and significance level was based on a 0.05. Methods were used Crosstabs analysis ,Paired T test and descriptive statistics. RESULTS & CONCLUSION: VA of hansen patients and old people did not differ by 0.29 +/-0.18 and 0.35+/-0.23. (p>0.05). CC of hansen patients and old people did differ by 0.55+/-0.26 and 0.44+/-0.21(p<0.05). Effective correction (%) of visual acuity of hansen patients and old people, there was a significant difference 22.58+/-18.05% and 32.24+/-27.72%(p<0.05). Constricted pupil size under light reflex of hansen patients and old people, there was a significant difference 3.13+/-1.34mm and 1.97+/-0.34mm (p<0.05). Hansen patients during normal illumination and light reflex is anisocoria (p>0.05). Old people during normal illumination and light reflex is normal (p<0.05). Direct light reflex state of hansen patients was normal 17.20% and abnormal 82.8%. Pupil's response velocity during light reflex of hansen patients was normal 3.4% and abnormal 96.6%. Pupil's reaction state during light reflex of hansen patients was normal 13.8%and abnormal 86.20%. Direct light reflex state of old people was normal 96.60%and abnormal 3.4%. Subjective symptoms were ranking 1.Dim sighted(23times) 2.Eyestrain(18times) 3.Tears(15times) of Hansen, that were ranking 1.Dim sighted(25times) 2.Tears(8times) 3.Pruritus(8times)of old people. Hansen patients and old people were not differ about result of CV test.
Aged ; Anisocoria ; Color Vision ; Humans ; Lighting ; Miosis ; Pupil ; Surveys and Questionnaires ; Reflex ; Refractive Errors* ; Visual Acuity ; Writing

Ross syndrome is characterized by a triad of segmental anhidrosis, tonic pupil, and generalized areflexia. Selective postganglionic autonomic denervation could be the differential diagnostic point for other diseases of the autonomic nervous system. Here we report a patient with regional anhidrosis in his left hand and sole, and anisocoria. An evaluation of sweating and the pupillary response together with generalized areflexia confirmed the diagnosis of Ross syndrome. The finger wrinkle test is a simple and useful tool for revealing segmental sympathetic denervation.
Anisocoria* ; Autonomic Denervation ; Autonomic Nervous System ; Diagnosis ; Fingers* ; Hand ; Humans ; Hypohidrosis* ; Sweat ; Sweating ; Sympathectomy ; Tonic Pupil

PURPOSE: To report two cases of temporary severe neurogenic blepharoptosis after successful reconstruction of orbital medial wall fracture. CASE SUMMARY: A 36-year-old woman and a 52-year-old man received orbital medial wall reconstruction with Medpor(R) for large fractures. Before the operation, the patients had only moderate swelling of the lid and periorbital ecchymosis. There were no limitations of extraocular muscles or ptosis. The operations were successful, although the patients developed unilateral complete ptosis with totally impaired levetor muscle function immediately after recovering from anesthesia. There were no anisocoria or limitations of the extraocular muscles. After oral steroid therapy, the patients began to improve on postoperative day 4 and after one month, respectively, and recovered to normal lid height and levator function after two months. CONCLUSIONS: Blepharoptosis after orbital medial wall reconstruction may result from ischemic damage at the end of the superior branch of the oculomotor nerve in the orbit due to compressive and tractional manipulation. Although very rare and temporary, this complication should be considered important because the occurrence can be unpredictable and may cause dissatisfaction to the surgeon and the patient after a successful operation.
Adult ; Anesthesia ; Anisocoria ; Blepharoptosis ; Ecchymosis ; Female ; Humans ; Middle Aged ; Muscles ; Oculomotor Nerve ; Orbit ; Traction

Emergence from anesthesia may be neurologically unsatisfactory. Delayed awakening after general anesthesia is most commonly caused by the effects of anesthetic drugs, but primary central neurologic events (hemorrhage, ischemia, and embolus, etc) that occur during surgery can cause failure to awaken. We experienced a patient whose emergence was delayed from general anesthesia for zygomatic bone savage. The patient had such unexpected focal neurologic abnormalities as left ankle clonus and anisocoria (right dilation). Brain CT revealed acute subdural hematoma as a cause of delayed emergence in the postanesthetic care unit. An emergency craniectomy was performed to evacuate the hematoma, but the patient failed to regain consciousness following surgery. The patient regained consciousness on the 28th postoperative day, and had left hemiparesis and right blindness.
Anesthesia ; Anesthesia, General* ; Anesthetics ; Anisocoria ; Ankle ; Blindness ; Brain ; Consciousness ; Embolism ; Emergencies ; Hematoma ; Hematoma, Subdural, Acute* ; Humans ; Ischemia ; Paresis