Not your everyday anisocoria: angel's trumpet ocular toxicity

Abstract

A 12-year-old boy was brought to the emergency department by his parents with new-onset anisocoria. He complained of blurry vision and of his left pupil being larger than the right. His visual acuity was normal and examination revealed a painless left mydriasis. A thorough history and targeted examination yielded the diagnosis of pharmacologic mydriasis caused by ocular exposure to Angel's Trumpet (Datura suaveolens), a plant containing toxic alkaloids with anti-cholinergic properties. The patient and his family were spared expensive and time-consuming tests (e.g., magnetic resonance imaging) or further referral. His symptoms resolved spontaneously in 3 days.