Anisocoria in an intubated patient with COVID-19

Sam Myers; Minak Bhalla; Rohit Jolly; Saurabh Jain

doi:10.1136/bcr-2020-240003

Anisocoria in an intubated patient with COVID-19

BMJ Case Rep. 2021 Jul 22;14(7):e240003. doi: 10.1136/bcr-2020-240003.

Authors

Sam Myers^{1

2}, Minak Bhalla³, Rohit Jolly⁴, Saurabh Jain⁴

Affiliations

¹ Department of Ophthalmology, Whittington Health NHS Trust, London, UK sam.myers1@nhs.net.
² UCL Medical School, University College London, London, UK.
³ Department of Ophthalmology, Whittington Health NHS Trust, London, UK.
⁴ Department of Ophthalmology, Royal Free London NHS Foundation Trust, London, UK.

Abstract

The effects of COVID-19 on the eye are still widely unknown. We describe a case of a patient who was intubated and proned in the intensive care unit (ICU) for COVID-19 and developed unilateral anisocoria. CT venogram excluded a cavernous sinus thrombosis. MRI of the head showed microhaemorrhages in the midbrain where the pupil reflex nuclei are located. After the patient was stepped down from ICU, intraocular pressure (IOP) was found to be raised in that eye. A diagnosis of subacute closed angle glaucoma was made. It is important for clinicians to rule out thrombotic causes in patients who develop acute anisocoria. It is also crucial to measure IOP in patients who develop ophthalmic pathology and have been proned for extended periods.

Keywords: glaucoma; ophthalmology; pupil.

Publication types

Case Reports

MeSH terms

Anisocoria / diagnosis
Anisocoria / etiology
COVID-19*
Glaucoma, Angle-Closure* / diagnosis
Humans
Intraocular Pressure
Pupil
SARS-CoV-2