A 73-year-old woman with a past medical history of stroke, hypertension, and end-stage
renal disease, on hemodialysis, presented to the Emergency Department for altered
mental status and slurred speech. On physical examination, she had a right pupillary
defect in a star-like pattern, with initial concern for a blown pupil (Figure), raising suspicion for acute stroke. Her initial blood pressure was 230/110 mm Hg,
and neuroimaging was unremarkable for stroke. She was admitted for hypertensive emergency.
FigureRight festooned pupil in the shape of a star due to multiple posterior synechiae.
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References
- Iris and pupils.The Massachusetts Eye and Ear Infirmary Illustrated Manual of Ophthalmology. Saunders Elsevier, 4th ed. New York2014: 257-263 (4th ed)
Sowka J, Kabat AG. Develop a flare for uveitis. Review of Optometry. January 15, 2006. Available at: https://www.reviewofoptometry.com/article/develop-a-flare-for-uveitis. Accessed October 1, 2022.
Article Info
Publication History
Published online: November 06, 2022
Publication stage
In Press Journal Pre-ProofFootnotes
Funding: None.
Conflicts of Interest: None.
Authorship: All authors had access to the data and a role in writing this manuscript.
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© 2022 Elsevier Inc. All rights reserved.
