Pupil examination

Pupil Examination. A meaningful evaluation of pupils after drug-induced mydriasis or miosis is impossible. Pupillary examination, including pupil size and responsiveness, should be undertaken before instilling mydriat-ics or miotics.The presence and nature of direct reflexes as well as the presence or absence of a relative afferent pupillary defect should be recorded. 

Mydriatics and Cycloplegics Tropicamide, cyclopentolate Dilation of pupil Examine the fundus of eye Examination of Eye-drop solution, eye ointment... 

Dapiprazole acts by blocking die a-adrenergic receptor in smootii muscle and produces miosis through an effect on the dilator muscle of the iris. The drug is used primarily after ophtiialmic examinations to reverse the diagnostic mydriasis (dilation of the pupil). 

These drugs dilate the pupil (mydriasis), constrict superficial blood vessels of the sclera, and decrease the formation of aqueous humor. Depending on the specific drug and strength, these dru may be used before eye surgery in the treatment of glaucoma, for relief of minor eye irritation, and to dilate the pupil for examination of the eye... 

Inspection of the retina during an ophthalmoscopic examination is greatly facilitated by mydriasis, or the dilation of the pupil. Parasympathetic stimulation of the circular muscle layer in the iris causes contraction and a decrease in the diameter of the pupil. Administration of a muscarinic receptor antagonist such as atropine or scopolamine prevents this smooth muscle contraction. As a result, sympathetic stimulation of the radial muscle layer is unopposed, causing an increase in the diameter of the pupil. These agents are given in the form of eye drops that act locally and limit the possibility of systemic side effects. 

A 36-year-old male heroin addict is seen in the ED because he cannot be aroused from sleep On examination, he has shallow breathing and pinpoint pupils. Naloxone is administered, and the patient wakes up. Which of the opiate receptor subtypes that binds naloxone is responsible for reversing the respiratory depression and miosis ... 

Mendeleev studied mathematics, physics, and chemistry at the Institute. Shortly after he was admitted, his mother died. A year later his sister Liza, who had accompanied them to St. Petersburg, died also. But Mendeleev continued to work hard at his studies, graduated first in his class in 1855, and was awarded a gold medal. However, as was the custom, the examiners praised not Mendeleev but his chemistry professor A. A.Voskresenski, for having produced such a fine pupil. 

Serine is, as yet, the only member of the oxyaraino acids of the aliphatic series which has been isolated with certainty from the mixture of decomposition products of the proteins. It was first obtained in 1865 by Cramer from silk-gelatin, and was not again obtained until E. Fischer isolated it from the various proteins which he emd his pupils have examined. 

On day 4, the patient began to lose consciousness and he became unresponsive. His last dose of codeine was 12 hours earlier. The patient was hypoxemic and was ventilated to improve his oxygen tissue levels. Clinical examination revealed pinpoint pupils, no eye opening, and no verbal response. 

The edema may be benign, thus enabling a complete examination of all the structures of the anterior chamber iris, pupil, and lens. The edema may be medium when it makes the cornea translucent and then only a faded iris can be observed. It may also be important, and then it creates a porcelain Uke cornea, meaning a white cornea, in which none of the structures of the anterior chamber are visible. This stromal edema must not be taken for an epithelial necrosis due to coagulation, which is sometimes present in some specific types of bums. The epithelium with a necrosis can and must be taken off with a cotton wool stick or a scarificator. This epithelium is easy to separate from the eye, in the form of a whitish squame and then lets the transparent stroma to appear (Fig. 7.10). 

The final portion involved further examination of the eyes. DREs estimated the diameter of each pupil to the nearest 0.5 mm under conditions of ambient room light, nearly total darkness, indirect light, and direct light. While illuminating the eyes under direct light from a penlight for 15 s, DREs assessed constriction of the pupils and fluctuation of pupillary diameter. Last, DREs measured pulse and assessed muscle tone, attitude, coordination, speech, breath odor, and facial appearance. 

The observable physical changes are pupil dilation, increased pulse rate and blood pressure and, in some instances, dizziness, nausea or tremor. Stephen Sz ra and his associates examined such effects closely in a series of papers (eleven of these are listed in Brimblecombe and Pinder s bibliography at the end of their tryptamine chapter), concluding that these were minor. 

William Irvine (1743—87) graduated MD at University of Glasgow in 1766, where he was a favoured pupil and collaborator of Black. Irvine was lecturer in materia medica at the University from 1766 and lecturer in chemistry from 1769, holding both positions until his early death. Irvine became known for an alternative non-chemical explanation of the phenomenon of latent heat as involving a change in the heat capacity of substances. For the moment we need only note that Irvinist treatments of heat rejected the idea that heat became latent by being chemically combined with other substances. I examine his ideas in more detail in Chapter 4. 

During an eye examination at the hospital, it was found that Rob s IOP was above the normal range in the left eye (33 mmHg) and in the right eye was slightly increased (21.5 mmHg). In addition, it was found that the angle between his cornea and iris was very narrow this was worse in the left eye, where the pupil was dilated. Rob confirmed that eye problems are common in his mum s family. 

Some months after Jim s unpleasant experience with the insecticide, he attended an eye clinic for a routine examination. Following the visit, his pupils were widely dilated and he found it difficult to focus on objects. 

Atropine is used in eye examinations to dilate the pupil and allow visualization of the retina. 

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