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ARS Home » Pacific West Area » Logan, Utah » Poisonous Plant Research » Research » Publications at this Location » Publication #383222
Research Project: Understanding and Mitigating the Adverse Effects of Poisonous Plants on Livestock Production Systems

Location: Poisonous Plant Research

Title: Isolated dilated pupil

Author
item RUIZ-BARRIO, INIGO - AUTONOMOUS UNIVERSITY OF BARCELONA
item GUISADO-ALONSO, DANIEL - AUTONOMOUS UNIVERSITY OF BARCELONA
item BULNES-GONZALEZ, V - AUTONOMOUS UNIVERSITY OF BARCELONA
item Green, Benedict - Ben

Submitted to: The BMJ
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/24/2022
Publication Date: 3/31/2022
Citation: Ruiz-Barrio, I., Guisado-Alonso, D., Bulnes-Gonzalez, V., Green, B.T. 2022. Isolated dilated pupil. The BMJ. Article 376. https://doi.org/10.1136/bmj-2021-069133.
DOI: https://doi.org/10.1136/bmj-2021-069133

Interpretive Summary: Description of a plant poisoning by Angel's trumpet and discussion of the parasympatheitic nervous system.

Technical Abstract: A 50-year-old woman presented to the emergency room with blurred vision and pupillary asymmetry, which she had noticed 3 hours before, while pruning the garden. She had no headache, eye pain or diplopia. Corrected visual acuity in the right eye was 0.8, in the left eye 1. Examination revealed right mydriasis with abolished direct light reflex, consensual light reflex and accommodation reflex. The rest of the neurological examination was normal, to highlight her eye movements and deep muscle reflexes. Pilocarpine eye drops were instilled in both eyes at concentrations of 0.125% and 1%, with the persistence of mydriasis. Eventually, pilocarpine at 2% was instilled, and after 10 minutes there was a complete remission of signs and symptoms. She was asked for a photo of her garden, where angel’s trumpet plants were identified.