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Impressum
Bilateral congenital dilated pupils with lack of accommodation and patent ductus arteriosus
Weber A., Gräf M.
Department of Ophthalmology, Gießen
Objective: We describe a 4-month-old girl who had bilateral congenital
dilated pupils in association with patent ductus arteriosus.
Methods: There was no family history of ocular abnormalities. At
the age of 7 days this girl underwent corrective operation of her heart
disease. We performed ocular examination including handheld slitlamp biomicroscopy,
indirect ophthalmoscopy, objective retinoscopy and pharmacologic pupillary
testing.
Results: Ocular examination showed wisps of tissue radiating centrally
from the iris. Both pupils were circular, 7mm in diameter with lack of
respone both to bright light and pilocarpine up to 1% concentration. On
the left eye there was a transillumination defect in the nasal part of
the iris. The remainder of the anterior ocular segment was normal. Even
after instillation of miotics there was no change of the refractive error
of +3dpt measured by retinoscopy. The fundi appeared normal except for
small arterial loops close to the optic nerve head.
Conclusion: Congenital dilated pupil is a rare condition. Typically
it affects both eyes. Two cases have been reported with a patent ductus
arteriosus similar to our case. Obviously there is a systematic connection
between the patent ductus arteriosus and the ocular abnormality which
includes the lack of ciliar muscle function.