Q: Pharmacologic mydriasis is very common in ICU. How it can be confirmed?
Answer: Many drugs in ICU can cause mydriasis such as atropine, phenylephrine, clonidine, scopolamine patch, and aerosolized ipratropium.
Pharmacologic mydriasis can be confirmed by demonstrating partial or no constriction by application of a 1% pilocarpine eye drop. In all other causes of the dilated pupil (except direct damage to pupillary sphincter from trauma or surgery), 1% pilocarpine will cause maximal pupillary constriction.
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