Pharmacologic anisocoria due to nebulized ipratropium bromide: A diagnostic challenge

Anisocoria may be physiological or seen in fatal conditions, such as intracranial hemorrhage. Newly developing anisocoria may cause confusion and diagnostic difficulty in the emergency department (ED). A 35-year-old female was admitted to the ED with an asthma attack and dyspnea. On examination, the patient was observed to have bilateral rhonchi and was treated with nebulized albuterol (salbutamol) and ipratropium bromide. After the treatment, the dyspnea improved, and mydriasis developed in the left eye (left pupil diameter 9  mm, right 4 mm).
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research