• Journal of Physiology & Pathology in Korean Medicine
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• v.35 no.2
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• pp.81-85
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• 2021

This study aims to report a case of oculomotor nerve palsy with mydriasis improved by Sa-Am acupuncture (大腸正格). The patient visited our clinic due to Right oculomotor nerve palsy with symptoms such as periocular pain, diplopia, vertigo, ptosis, eye adduction disorder, and mydriasis on November 11th, 2019. For the treatment, Sa-Am acupuncture (大腸正格) which used to give a significant effect on eye diseases and headaches and to remove toxins from the body was performed every time the patient visited the clinic. About a month after the treatment, ptosis disappeared, and eye adduction disorder also changed from -2 to 2 points, showing a significant improvement. Subjective symptoms such as vertigo, diplopia, and eye pain also significantly decreased from 13 to 4 points. At the second month of treatment, the eye adduction disorder improved to a normal level, and subjective ocular discomforts disappeared. The pupil size decreased from 5 mm to 2.5 mm. After 3-4 months from the start of treatment, most of the symptoms including the light reflex returned to normal. After a total of 32 acupunctures treatment, subjective symptoms such as periocular pain, diplopia and vertigo, as well as ptosis and eye adduction disorder disappeared, and the pupil size, including the light reflex, also improved to the normal level.

• Journal of Veterinary Science
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• v.24 no.4
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• pp.59.1-59.13
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• 2023

Background: Rocuronium bromide has been evaluated as a mydriatic agent in birds, but the species applied were limited and the dose and effect were variable. Objective: This study aims to evaluate the efficacy of topical rocuronium bromide as mydriatics in 4 species according to horizontal palpebral fissure length: Feral pigeon (Columba livia), Common kestrel (Falco tinnunculus), Northern boobook (Ninox japonica), and Eurasian eagle owl (Bubo bubo). Methods: A total of 32 birds (8 for each species) were included as pre-releasing examination. Rocuronium bromide was instilled in one randomly selected eye of each bird based on palpebral fissure length criteria (0.5 mg/50 µL for pigeons, 1 mg/100 µL for kestrels and boobook owls, and 2 mg/200 µL for eagle owls). The contralateral eye was used as control and treated with normal saline. After instillation of the drug, pupil diameter, pupillary light reflex, intraocular pressure, heart rate, and respiratory rate were evaluated at 10 min intervals up to 180 min and at 30 min intervals up to 360 min. Results: Statistically significant mydriasis was obtained in all birds (p < 0.001). However, in boobook and eagle owls, marked mydriasis persisted until 360 min. Side effects including corneal erosion and lower eyelid paralysis were common, which was observed in 26/32 birds. Blepharospasm was also noted during this study. No systemic adverse signs were observed. Conclusions: Rocuronium bromide could be a good mydriatics option for 4 species of birds, however, further studies are needed to find lowest effective dose to reduce drug-related side effects.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.2
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• pp.93-96
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• 2015

Although inferior alveolar nerve block is one of the most common procedures performed at dental clinics, complications or adverse effects can still occur. On rare occasions, ocular disturbances, such as diplopia, blurred vision, amaurosis, mydriasis, abnormal pupillary light reflex, retrobulbar pain, miosis, and enophthalmos, have also been reported after maxillary and mandibular anesthesia. Generally, these symptoms are temporary but they can be rather distressing to both patients and dental practitioners. Herein, we describe a case of diplopia caused by routine inferior alveolar nerve anesthesia, its related physiology, and management.

• Archives of Craniofacial Surgery
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• v.17 no.3
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• pp.154-157
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• 2016

Transient anisocoria is rare during blowout fracture reconstruction. We report a case of transient anisocoria occurring during medial blowout fracture reconstruction and review the relevant literature. A 54-year-old woman was struck in the face and was admitted for a medial blowout fracture of the left eye. During the operation, persistent bleeding occurred. To control this bleeding, a 1% lidocaine solution with 1:200,000 epinephrine was applied to the orbital wall with cotton pledgets. In total, 40 mL of local anesthetic was used for the duration of the operation. After approximately three hours of the surgery, the ipsilateral pupil was observed to be dilated, with sluggish response to light. By 3 hours after the operation, the mydriasis had resolved with normal light reflex. In conclusion, neurological and ophthalmologic evaluation must be performed prior to blowout fracture surgery. Preoperative ophthalmic evaluation is simple and essential in ruling out any preexisting neurologic condition. Moreover, surgeons must be aware of the fact that excessive injection of lidocaine with epinephrine for hemostasis during orbital wall surgery can result in intraoperative anisocoria. Anisocoria-related situations must be addressed in a proficient manner through sufficient understanding of the mechanism controlling the pupillary response to various stimuli.

• The Journal of the Society of Stroke on Korean Medicine
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• v.20 no.1
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• pp.33-42
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• 2019

■ Objectives The purpose of this case report is to show the effect of Traditional Korean Medicine(TKM) on a patient with Miller Fisher Syndrome. ■ Methods A patient with Ataxia, Diplopia, Mydriasis diagnosed as Miller Fisher Syndrome was treated with herbal medication, acupuncture, electro-acupuncture, and press needles. Then we evaluated the improvement with the size of pupil, NRS(Numeral Rating Scale) of Diplopia, Assessment for Gait disturbance. ■ Results We could observe decrease in pupil size and NRS of Diplopia and improve in assessment for gait disturbance after the TKM treatment. ■ Conclusion This case showed the effect of TKM treatment on Miller Fisher syndrome.

• Journal of Yeungnam Medical Science
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• v.29 no.1
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• pp.58-60
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• 2012

Central anticholinergic syndrome occurs when an anticholinergic substance works in vivo or as a result of the insufficient release of acetylcholine. Its symptoms include confusion, agitation, behavioral change, hallucination, blurred vision, and dysarthria. Occasionally, these symptoms occur with the use of a scopolamine patch. A 54-year-old female complained of behavioral change and confused mentality. She attached a scopolamine patch at the postauricular area in the morning of the day before her hospital visit. Neurological examination revealed bilateral symmetric mydriasis without light reflex. The brain MRI was normal, and electroencephalography showed nonspecific abnormalities. The patient recovered completely after the removal of the scopolamine patch.

• Journal of Oriental Neuropsychiatry
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• v.12 no.1
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• pp.201-207
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• 2001

Oculomotor nerve is the third cranial nerve, controlls four of the six extraocular muscles(superior rectus muscle, medial rectus muscle, inferior rectus muscle and inferior oblique muscle), levator palpebrae superioris muscle, cilliary muscle and muscle sphincter pupillae. In the oculomotor nerve palsy, limited oculogyration, diplopia, blepharoptosis, accomodation paralysis and mydriasis can be occured. We experienced an improved case of the oculomotor nerve palsy patient treated with oriental medicine for 25days. We used herbal medicine and acupuncture. Based on this experience, it is considered that oriental medicine can be applied to the treatment of the oculomotor nerve palsy.

• Journal of Chest Surgery
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• v.24 no.1
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• pp.106-112
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• 1991

A 37-year old man was admitted due to the left subauricular mass of 6 month duration which was 3 x 4cm sized, pulsatile and slowly growing He was suffered from the intermittent left facial and auricular pain radiating to the occipital area. The carotid angiography revealed 3x4cm sized saccular aneurysm of the left internal carotid artery just above the carotid bifurcation, extending to the mandibular angle level. He was planned to be operated under the direct clamp of internal carotid artery or shunting procedure. But, the back pressure of the internal carotid was 35mmHg, which suggested adequate cerebral collateral. Thereby, aneurysmectomy and restoration of cerebral blood flow with saphenous vein graft was done under the direct clamp of internal carotid artery for 25 minutes. Although mild transient neurologic sequelae such as mydriasis, tongue deviation for 10 days, he recovered completely without any complication. The aneurysmal sac had no thrombus and pathologic finding was compatible with congenital origin.

• Journal of Veterinary Clinics
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• v.24 no.1
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• pp.73-75
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• 2007

Heat stroke can lead multi-organ damage with hemorrhage and necrosis in the lungs, heart, liver, kidneys, brain and Ut. Heat stroke occurs when the elevation of core body temperatures induce a failure of thermoregulatory mechanism. A four-year-old male African Lion(Panthera leo) showed clinical signs such as panting, tachycardia, hyperthermia, unconsciousness and mydriasis under He hish humidity and hot weather. Clinical treatment and pouring cool water was unsuccessful. Grossly, congestion of lungs and pleura was observed. Yellowish discoloration was observed in the renal cortex. Microscopically, the coagulative necrosis in kidney and congestion of lungs and spleen were observed. In our knowledge, this case was closely associated with acute heat stroke.

• Archives of Pharmacal Research
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• v.19 no.5
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• pp.386-389
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• 1996

The in vivo behaviour of phenylephrine hydrochloride in different vehicles like gels of Carbopol $907^circledR$, Carbopol $934P^circledR$ and latex system of cellulose acetate hydrogen phthalate(CAHP) was evaluated by measuring the reduction in intraocular pressure and the mydriatic activity. The parameters that haave been utilised to assess the performance of the formulations were the area under the curve (AUC), the maximum mydriasis $(I_{max})$, ethe time of maximum response $(T_{max})$ and the duration of activity (D). The influence of viscosity and mucoadhesion on the bioavailability parameters has also been investigated. Carbopol 934P and CAHP formulations showed prolonged duration of action and greater AUC compared to Carbopol 907 aqueous solution(P<0.05).