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Variations in the size of the pupils may be due to either local or remote conditions, morbid or physiologic. Glaucoma, myopia, amblyopia and amaurosis are likely to be attended with some degree of pupillary dilatation, while hyperopia, hyperesthesia of the retina and advanced age are usually attended with contraction of the pupil. The pupil will be large when the fibers it derives from the third nerve are paralyzed or those derived from the cervical sympathetic are irritated and it will be small under the reverse conditions. These effects may be induced by drugs and other physiologic agencies, or by inflammation, traumatism, new growths and other morbid processes. The usual reactions to stimuli fail whenever the reflex arc through either the cervical sympathetic or the optic nerve on the one hand, and the third nerve on the other, is interrupted at any part of its course. The reaction with convergence and
CHANGES IN THE PUPILLARY REACTIONS IN THE INSANE. JAMA. 1896;XXVII(23):1209–1210. doi:10.1001/jama.1896.02431010037006
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