Pupillary signs in a comatose patient
Pupil characteristics can be used to identify the cause of coma in a patient. It also helps in determining the treatment. The important pupillary signs are given below:
| Pupil | Condition |
|---|---|
| Pinpoint pupils | Pontine lesion / morphine poisoning |
| Moderately dilated, non reactive, fluctuating | Mid brain lesions |
| Unilateral dilated, non reactive | Third nerve damage – due to transtentorial herniation of temporal lobe / traction of third nerve against posterior cerebral artery |
| Bilateral dilated, non reactive | Terminal states / Ischemic brain damage / Atropine / Belladonna poisoning |
| Small, equal, reactive | Toxic / Metabolic causes of coma |
