Differential Diagnosis for Non-Palpable Pupils
- Single Most Likely Diagnosis
- Amaurosis Fugax: This condition, characterized by temporary blindness in one eye, can lead to non-palpable pupils due to the transient nature of the visual loss. The pupil may not react to light during an episode.
- Other Likely Diagnoses
- Ocular Ischemic Syndrome: Reduced blood flow to the eye can cause non-palpable pupils, along with other symptoms like vision loss and eye pain.
- Diabetic Third Nerve Palsy: This condition can affect the oculomotor nerve, leading to pupil dilation and potentially non-palpable pupils.
- Adie's Palsy: A condition affecting the nerves controlling the eye muscles, leading to a dilated pupil that reacts poorly to light.
- Do Not Miss Diagnoses
- Pituitary Apoplexy: A potentially life-threatening condition where the pituitary gland suddenly hemorrhages, leading to visual disturbances, including non-palpable pupils.
- Stroke or Cerebral Vasculitis: Certain types of stroke or cerebral vasculitis can affect the brain areas controlling pupil reaction, leading to non-palpable pupils.
- Traumatic Brain Injury: Severe head trauma can damage the nerves controlling pupil reaction, resulting in non-palpable pupils.
- Rare Diagnoses
- Holmes-Adie Syndrome: A rare condition characterized by a dilated pupil that reacts poorly to light, often accompanied by decreased or absent deep tendon reflexes.
- Fisher Syndrome: A rare neurological disorder that can cause non-palpable pupils, among other symptoms like ophthalmoplegia and ataxia.
- Botulism: A rare but potentially deadly illness caused by a toxin that can affect the nerves controlling pupil reaction, leading to non-palpable pupils.