Afferent Pupillary Defect

• afferent pupillary fibers affected
• slight dilation of pupil with direct stimulation and cessation of direct stimulation to the other eye (“Swinging Flashlight” test or Marcus-Gunn Pupil)

Adie’s Syndrome

• fixed, dilated, tonic pupil
• weak or absent direct and consensual pupil reactions
• unknown etiology

Anisocoria

• unequal pupil sizes

Argyle-Robertson Pupil

• miotic pupils O.U.
• no direct or consensual pupil reflex
• near reflex normal
• suggests syphilis

Bell’s Palsy

• VII nerve damage
• paresis and drooping of one side of face

Cavernous Sinus Syndrome

• III, IV, V, VI nerves affected
• proptosis
• exophthalmos
• papilledema
• headache

Crocodile Tears

• misdirected nerve fibers after damage to facial nerve enervating the lacrimal gland, resulting in tearing with anticipation of eating

Cushing’s syndrome

• steroid or adrenal gland induced
• moon face
• buffalo hump
• posterior subcapsular cataracts

Duane’s syndrome

• attempted adduction leads to retraction and ptosis

Efferent Pupillary Defect

• III nerve or pupillary muscle affected
• loss of consensual and direct pupillary reflex in affected eye
• consensual and direct pupillary reflex in unaffected eye

Foster-Kennedy Syndrome

• ipsilateral optic atrophy
• contralateral papilledema

Gradengo Syndrome

• VI nerve palsy
• esotropia
• V nerve irritation
• pain

Horner’s syndrome

• miosis
• ptosis
• anhydrosis
• enophthalmos
• lesion of the sympathetic pathway in the brain stem to cervical area

Marcus-Gunn Syndrome

• “jaw-winking” syndrome
• ptotic lid raises when ipsilateral pterygoid muscle is stimulated, as in chewing, sucking, or opening the mouth
• amblyopia and strabismus common

Mobius Syndrome

• III, VI, VII nerve palsy (proptosis, ptosis, esotropia)

Oculogyric Crisis

• spastic upward conjugate movement of eyes
• head held back

Ophthalmoplegia – Internal

• III nerve paralysis
• dilated fixed pupils
• stroke

Ophthalmoplegia – External

• III, IV, and VI nerve damage
• muscle palsies
• no upgaze
• accommodative spasm

Parinaud’s Syndrome

• no upgaze
• nystagmus on attempted convergence
• pseudo-Argyll-Robertson pupils (large with sluggish reaction to light)
• bilateral papilledema common
• pinealoma and other tumours affecting the mid-brain, multiple sclerosis, vascular lesions