Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct 26;10(11):1739.
doi: 10.3390/children10111739.

Acute Pupillary Disorders in Children: A 10-Year Retrospective Study of 101 Patients

Giacomo Garone  1   2 , Marco Roversi  3 , Mara Pisani  4 , Francesco La Penna  4 , Antonio Musolino  3 , Sebastian Cristaldi  4 , Anna Maria Musolino  4 , Amanda Roberto  5 , Gianni Petrocelli  6 , Antonino Reale  4 , Fabio Midulla  7 , Alberto Villani  4   8 , Umberto Raucci  4
Affiliations

Acute Pupillary Disorders in Children: A 10-Year Retrospective Study of 101 Patients

Giacomo Garone et al. Children (Basel). .

Abstract

Background: To date, no study has specifically examined children with acute-onset pupillary motility disorders (APMD). Especially in the Emergency Department (ED), it is crucial to distinguish benign and transient conditions from life-threatening or urgent conditions (UCs). The aim of the study is to describe the clinical characteristics of children with APMD and their association with an increased risk of UCs.

Methods: We conducted a pediatric retrospective study of APMD referred to ED over a 10-year period. We described the characteristics in the overall sample and in two subgroups divided according to urgency of the underlying condition. Furthermore, we applied a logistic regression model to identify the variables predictive of LT condition.

Results: We analyzed 101 patients. In 59.4%, the APMD was isolated. In patients with extra-ocular involvement, the most frequently associated features were altered consciousness, headache, and vomiting. Exposure to toxic agents was reported in 48.5%. Urgent conditions occurred significantly more frequently in older children, presenting bilateral APMD and/or other ocular or extra-ocular manifestations.

Conclusions: Our study shows that UCs most commonly occur in patients presenting with bilateral APMD and other associated features. In unilateral/isolated APMD ophthalmological examination, exclusion of toxic exposure and observation until resolution of symptoms should be recommended.

Keywords: children; miosis; mydriasis; pediatrics; pupillary motility.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study flowchart.
See this image and copyright information in PMC

References

    1. Raucci U., Parisi P., Vanacore N., Ferro V., Garone G., Sancetta F., Petroni S., Pro S., Rossi R., Reale A., et al. A cohort study on acute ocular motility disorders in pediatric emergency department. Ital. J. Pediatr. 2018;44:62. doi: 10.1186/s13052-018-0502-0. - DOI - PMC - PubMed
    1. Gross J.R., McClelland C.M., Lee M.S. An approach to anisocoria. Curr. Opin. Ophthalmol. 2016;27:486–492. doi: 10.1097/ICU.0000000000000316. - DOI - PubMed
    1. Levin A.V. Eye strabismus. In: Fleisher G.R., Ludwig S., editors. The Textbook of Pediatric Emergency Medicine. 6th ed. Lippincott Williams & Wilkins; Philadelphia, PA, USA: 2010. pp. 281–286.
    1. Nye C. A child’s vision. Pediatr. Clin. N. Am. 2014;61:495–503. doi: 10.1016/j.pcl.2014.03.001. - DOI - PubMed
    1. Caglayan H.Z., Colpak I.A., Kansu T. A diagnostic challenge: Dilated pupil. Curr. Opin. Ophthalmol. 2013;24:550–557. doi: 10.1097/ICU.0000000000000005. - DOI - PubMed

LinkOut - more resources