Anisocoria in inner ear lesions

Area of Science:

• Ophthalmology
• Neurology
• Otolaryngology

Background:

• Inner ear pathologies can affect cranial nerves and autonomic pathways.
• Vestibular system dysfunction is known to influence sympathetic nervous system activity.

Purpose of the Study:

• To investigate the relationship between inner ear lesions and anisocoria.
• To determine the prevalence and characteristics of anisocoria in patients with unilateral inner ear diseases.

Main Methods:

• Experimental study in rabbits to observe pupil response to induced inner ear lesions.
• Clinical observation of 134 patients with unilateral inner ear diseases.
• Pharmacological testing with neosynephrine to assess pupillary response.

Main Results:

• Rabbits with irritative inner ear lesions showed pupil dilation; paretic lesions caused constriction.
• Anisocoria was observed in 54.5% of patients with unilateral inner ear disease.
• Neosynephrine induced or exacerbated anisocoria in 68.5% of affected patients, with the healthy pupil often being smaller.

Conclusions:

• Anisocoria is a potential clinical sign associated with inner ear lesions.
• The findings suggest a vestibulo-sympathetic imbalance mediated through the superior cervical sympathetic ganglion contributes to anisocoria in inner ear disease.