Journal List > J Korean Ophthalmol Soc > v.60(9) > 1133045

Ahn, Kim, Kim, and Choi: An Unusual Case of Benign Episodic Bilateral Mydriasis

Abstract

Purpose

Although benign episodic mydriasis has been rarely reported worldwide, most of the reports so far have occurred in unilaterally. To report an unusual case of benign episodic bilateral mydriasis.

Case summary

Nineteen-year-old woman who presented with intermittent dilation of both pupils two months ago. She had difficulty on reading and doing tasks because of her visual blur. This symptom usually lasted for 1–2 hours, occurred once every 2–3 days, most frequently during stressful situations. Headaches and dizziness accompanied the eye symptoms, and her pupils were both 5 mm in a lighted room and both 7 mm in a dark room. All tests, including brain magnetic resonance imaging, showed no abnormal findings. We diagnosed her as benign episodic bilateral mydriasis. The frequency of her symptoms decreased during the university vacation period.

Conclusions

In the absence of ophthalmologic or neurologic abnormalities other than headaches in patients with transient mydriasis, benign episodic mydriasis should be considered as a differential diagnosis. Although benign episodic bilateral mydriasis has a unilateral predominance, for the first time the authors report that benign episodic mydriasis may occur in both eyes during same episode.

Figures and Tables

Figure 1

Episodic bilateral mydriasis. Both pupils dilated during an episode. (A) Facial photo of the patient in room light during an episode (B) slit-lamp photo of right eye in room light during an episode. (C) Slit-lamp photo of left eye in room light during an episode. Except for the mydriasis, the response to the light stimulation was normal that immediately contracted, so the two sides were shot as if they were dilated slightly differently due to the momentary pupil response to the flash light during the photo shoot, but the both sides were dilated to the same degree in actual observation.

jkos-60-901-g001

Notes

Conflicts of Interest The authors have no conflicts to disclose.

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