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Constricted pupil

  • Common ddx

    • narcotics (abuse or overdose)
  • Serious ddx

    • cholinergic effect:
      • pesticide/organophosphate poisoning
      • poisonous mushrooms
    • Horner's syndrome:
      • stroke (lateral pontine, medullary syndrome)
      • spinal cord lesion
      • carotid dissection
      • pancoast tumor
      • lung cancer, lymphoma
  • Labs

    • narcotic levels
    • organophosphate levels
    • UTox
    • CXR or CT if suspect thoracic tumor
    • head CT if suspect stroke
    • CT angiography if suspect carotid dissection

  • Print | Citations

    Disclaimer: MDHero Workups is for educational use only, and is not meant to replace the clinical judgement of a professional. We do not guarantee the accuracy of any information on this website.