- Anisocoria is when pupillary size is assymetric.
- Anisocoria suggests a lesion in the efferent fibers supplying the pupillary sphinter muscles.
- In order to localize the causative lesion, you must first determine which pupil is abnormal, the smaller one or the larger one.
- The smaller pupil is abnormal when the degree of assymetry is more pronounced in darkened settings.
- The larger pupil is abnormal when the degree of assymetry is more pronounced in bright light.