©Copyright 2019 by University Health Partners of Hawai‘i (UHP Hawai‘i). Although eye contamination with the Angel's trumpet plant is self-limited and resolves within a week, the appearance of a persistently unilateral mydriatic eye can be alarming to patients and clinicians, which too often results in an unnecessary, costly workup.Īngel's trumpet anisocoria mydriasis pediatric emergency medicine. It is critical when obtaining a history from a patient with such a presentation to ask explicitly about any contact with plants prior to onset of symptoms. The cause is usually an artery that gets torn by a skull fracture. In this condition, the difference between pupils is usually less than 1 mm. 2 Physiological anisocoria: About 20 of population has a slight difference in pupil size which is known as physiological anisocoria. This likely explains why even brief contact with the plant can result in unintentional contamination of the eye and in mydriasis. An epidural hematoma (EDH) is a collection of blood that forms between your skull and the dura mater, the outermost protective membrane covering your brain. Anisocoria is a common condition, defined by a difference of 0.4 mm or more between the sizes of the pupils of the eyes. The three active components occur in different parts of the plant, including on the small glandular hairs that cover the entire plant. The Angel's trumpet plant contains three active components which can result in mydriasis: hycosamine, atropine, and scopolamine. ICD-10-CM Diagnosis Codes that Support Coverage Criteria. Almost always, it happens in only one eye. We report the case of a 14-year-old girl who presented to the pediatric emergency department with acute anisocoria and unilateral mydriasis after contacting an Angel's trumpet plant and who had complete resolution of symptoms four days following eye contamination. dilated pupil in order to enhance the quality of the photographic record, unless unnecessary. Lymphoma Leukemia Multiple myeloma Trauma to the eye Symptoms You may not always know that you’re going to have retinal vein occlusion. Acute anisocoria and unilateral mydriasis is physically alarming to patients and diagnostically worrisome to clinicians.
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