Two weeks ago, I saw a patient who lost muscle tone of both eyes pupils. With light intensity varied, his pupils did not contract or change. They stayed enlarged. He had this condition 2 weeks prior to saying me. He has seen different eye doctors, specialists. There is no name of such a condition! even after his MRI test and blood test. Doctor told him that everything tested are fine. Therefore, no medicine was prescribed. A wait-and-see for 3 months for review.
Pupillary function – a simple discription
The iris receives both sympathetic and parasympathetic innervation: (1) the sympathetic nerves innervate the pupillary dilator muscles; and (2) the parasympathetic nerve fibers (from CN III) innervate the pupillary constrictor (sphincter) muscles as well as the ciliary apparatus for lens accommodation.
During the normal waking state the sympathetics and parasympathetics are tonically active. They also mediate reflexes depending in part on emotionality and ambient lighting. Darkness increases sympathetic tone and produces pupillodilation. Increased light produces increased parasympathetic tone and therefore pupilloconstriction (this also accompanies accommodation for near vision). During sleep, sympathetic tone is depressed and the pupils are small. Normal waking pupil size with average ambient illumination is 2 to 6 mm. With age, the average size of the pupil decreases. Approximately 25% of individuals have asymmetric pupils (anisocoria), with a difference of usually less than 0.5 mm in diameter. This must be kept in mind when attributing asymmetry to disease, particularly if there are no other signs of neurologic dysfunction.
Observation
First visit, his pupil size is about 80% of his iris size. No change when light intensity changes.
Treatment
Acupuncture eye meridians and trigger points. ESTIM. GuanMin, XueHai, ZuSanLi, HeGu, QuChi
Herbs
Bie Jia Jian 3 days
Observation
Second week, his pupil size about 60% of his iris size inside room.
Treatment
Continue with previous. ESTIM pass SiBai, ZanZu, upper SiShenChong, lower FengChi.
Observation
third week, pupil size about 40% of full iris size. Close to normal. Driving/walking without sun glasses.
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