Miosis is not a disease in itself, the pinpoint pupils are sign of underlying medical problems. What are the causes of constricted pupils? If pupils stay small and constricted during the test, abnormal myosis can be concluded. The examiner will instruct patient to look at a distant object and then he will gradually bring distant object within 5cm of the eyes. Accommodation reflex test for pupillary miosis uses distance as the indicator.The pinpoint pupils with an abnormal miotic tendencies does not change size, they stay constricted. The bright light is shone into eyes leads. The patient is asked to look into the distance by examiner. Swinging flashlight test for constricted pupils is performed in dim room light.There are few methods examiners can use to diagnose myosis and those are: Pupillary assessment is the best and the easiest way to determine abnormal pupillary miosis. It is also important to know that miosis can happen in one or both eyes. Size of miotic pupils or pinpoint pupils is 2 millimeters or less, the problem is more obvious if the environment is dark. Normal pupil size in bright light situations is between 2 and 4 millimeters, but in low light situations pupil size is from 4 to 8 millimeters. Abnormal miosis happens when pupils stay constricted even in low light situations. This is a normal function of the pupils and they are doing it thousands of time a day. But when eyes need more light and to prevent eye strain, pupils are dilating or getting bigger. In order to protect eye from too much light your pupils are constricting or getting smaller. When the environment is bright your pupils are small, and when the environment is dark your pupils are large. The size of the eye pupil is controlled by sphincter muscle of the iris and the iris dilator muscle. Its function is to control how much light gets in your eye. The pupil is the black circle in the center of the eye. Miotic pupils are symptom of brain hemorrhage.Pupillary miosis due to organophosphate poisoning.Horner’s syndrome can cause unilateral miosis.Constricted pupils induced by drugs or medications.What are the causes of constricted pupils?.Coma or brain death: Severe brain damage may cause a change in the size and reactivity of the pupils.Surgery: Eye surgery may result in alterations in pupil size, which can be permanent. Seizure: Sometimes seizures (a disruption of electrical activity in the brain) can cause changes in the pupils, which may be equal or unequal.Migraine: While it is not common, migraines can cause anisocoria.Vision loss: Significant vision defects can affect pupil size and reactivity.Increased intracranial pressure: This can result from a brain tumor, meningitis (inflammation of the fluid around the brain), or a stroke.Trauma: An injury affecting the eye or the brain may cause the pupils to be unequal.Inflammatory conditions, such as MS and sarcoidosis, also can do this. Inflammation: An infection affecting the eye or the cranial nerves can cause anisocoria.Cranial nerve damage: This can occur due to a stroke (a blockage of blood flow or bleeding in the brain), brain aneurysm (defect in a blood vessel), or a brain tumor.
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