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A 31-year-old female was admitted to the hospital for a pericardectomy secondary to constrictive pericarditis. On the fourth postoperative day, neurology was urgently consulted because of an alarming acute wide pupil. She had no headache, ocular pain, diplopia, ptosis or other neurologic symptoms. Neurologic examination showed left mydriasis (9 mm) while the right pupil measured 3 mm (figure 1). Pupillary light reflex was normal bilaterally. The remainder of the neurologic examination was unremarkable. There was decreased intraocular pressure in the left eye (9 mm Hg vs 12 mm Hg) as assessed by the consulted ophthalmologist who found no other abnormalities. Throughout the hospitalisation, …
Competing interests None.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed. This paper was reviewed by Kate Ahmad, Sydney, Australia.