Question 100

You are seeing an 8 year old with suspected new onset anisocoria (see photo). Right pupil is 4mm and left pupil is 3mm. You suspect a unilateral Horner’s syndrome vs physiologic anisocoria. To test for Horner’s syndrome, you place one drop of apraclonidine 0.5% in each eye. After 30 minutes, what do you expect to see if this patient truly has a unilateral Horner’s syndrome?

Right pupil constricts, left pupil dilates

Right pupil constricts, left pupil doesn’t change

Right pupil dilates, left pupil constricts

Right pupil doesn’t change, left pupil dilates

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