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Images in paediatrics
Case of a fixed and dilated pupil: acute anisocoria secondary to aerosol ipratropium bromide
  1. Laura Royce1,
  2. Chris Schulz2,
  3. Nick Brown3
  1. 1 Department of General Paediatrics, Salisbury NHS Foundation Trust, Odstock Road, Salisbury, SP2 8BJ, UK
  2. 2 Department of Ophthalmology, Salisbury NHS Foundation Trust, Salisbury, UK
  3. 3 Department of Paediatrics, Salisbury District Hospital, Salisbury, UK
  1. Correspondence to Dr Laura Royce, Community Child Health, Solent NHS Trust- west, Adelaide Centre Level 2, Western Community Hospital Campus, William MacCloed Way, Millbrook, Southampton, SO16 4XE, UK; l_royce{at}hotmail.com

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A 2-year-old boy was presented with acute anisocoria (figure 1). He had a history of DiGeorge syndrome, with right-sided perisylvian polymicrogyria, left-sided hemiplegia and seizure disorder. He was a known asthmatic, for which he was on ipratropium bromide through a spacer. His left pupil was maximally dilated and unreactive. Right pupillary reactions were normal. Acuity was 6/12 bilaterally with full extraocular movements, …

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Footnotes

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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