https://www.ecured.cu/index.php?action=history&feed=atom&title=Midriasis 2026-05-18T01:01:46Z Historial de revisiones para esta página en el wiki MediaWiki 1.31.16 https://www.ecured.cu/index.php?title=Midriasis&diff=4583147&oldid=prev 2025-06-12T19:30:09Z

<p></p> <table class="diff diff-contentalign-left" data-mw="interface"> <col class="diff-marker" /> <col class="diff-content" /> <col class="diff-marker" /> <col class="diff-content" /> <tr class="diff-title" lang="es"> <td colspan="2" style="background-color: #fff; color: #222; text-align: center;">← Revisión anterior</td> <td colspan="2" style="background-color: #fff; color: #222; text-align: center;">Revisión del 19:30 12 jun 2025</td> </tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l42" >Línea 42:</td> <td colspan="2" class="diff-lineno">Línea 42:</td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Manifestaciones clínicas ==</div></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Manifestaciones clínicas ==</div></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* <del class="diffchange diffchange-inline">'</del>''Síntomas frecuentes<del class="diffchange diffchange-inline">'</del>'':</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* ''Síntomas frecuentes'':</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">&#160; </del>* Fotofobia (sensibilidad a la luz)</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">*</ins>* Fotofobia (sensibilidad a la luz)</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">&#160; </del>* Visión borrosa (especialmente en cerca)</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">*</ins>* Visión borrosa (especialmente en cerca)</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">&#160; </del>* Deslumbramiento nocturno</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">*</ins>* Deslumbramiento nocturno</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* <del class="diffchange diffchange-inline">'</del>''Signos asociados<del class="diffchange diffchange-inline">'</del>'':</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* ''Signos asociados'':</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">&#160; </del>* Pupilas &gt;5mm no reactivas a la luz</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">*</ins>* Pupilas &gt;5mm no reactivas a la luz</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">&#160; </del>* Anisocoria (asimetría pupilar) en causas unilaterales</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">*</ins>* Anisocoria (asimetría pupilar) en causas unilaterales</div></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Diagnóstico diferencial ==</div></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Diagnóstico diferencial ==</div></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* <del class="diffchange diffchange-inline">'</del>''Midriasis benigna<del class="diffchange diffchange-inline">'</del>'': Variante anatómica normal</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* ''Midriasis benigna'': Variante anatómica normal</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* <del class="diffchange diffchange-inline">'</del>''Síndrome de Adie<del class="diffchange diffchange-inline">'</del>'': Pupila tónica + hiporreflexia</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* ''Síndrome de Adie'': Pupila tónica + hiporreflexia</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* <del class="diffchange diffchange-inline">'</del>''Parálisis del III par<del class="diffchange diffchange-inline">'</del>'': Ptosis + oftalmoplejía asociada</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* ''Parálisis del III par'': Ptosis + oftalmoplejía asociada</div></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Protocolo de evaluación ==</div></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Protocolo de evaluación ==</div></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>1. <del class="diffchange diffchange-inline">'</del>''Historia clínica<del class="diffchange diffchange-inline">'</del>'': Uso de fármacos, traumatismos, síntomas neurológicos</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>1. ''Historia clínica'': Uso de fármacos, traumatismos, síntomas neurológicos</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>2. <del class="diffchange diffchange-inline">'</del>''Examen pupilar<del class="diffchange diffchange-inline">'</del>'':</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>2. ''Examen pupilar'':</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">&#160; </del>* Reactividad a luz (directa y consensual)</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* Reactividad a luz (directa y consensual)</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">&#160; </del>* Prueba de acomodación-convergencia</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* Prueba de acomodación-convergencia</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>3. <del class="diffchange diffchange-inline">'</del>''Pruebas complementarias<del class="diffchange diffchange-inline">'</del>'':</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>3. ''Pruebas complementarias'':</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">&#160; </del>* TAC/RM cerebral si sospecha neurológica</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* TAC/RM cerebral si sospecha neurológica</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">&#160; </del>* Tonometría para descartar glaucoma</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* Tonometría para descartar glaucoma</div></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Abordaje terapéutico ==</div></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Abordaje terapéutico ==</div></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* <del class="diffchange diffchange-inline">'</del>''Midriasis fisiológica<del class="diffchange diffchange-inline">'</del>'': No requiere tratamiento</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* ''Midriasis fisiológica'': No requiere tratamiento</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* <del class="diffchange diffchange-inline">'</del>''Inducida por fármacos<del class="diffchange diffchange-inline">'</del>'': Suspender agente causal</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* ''Inducida por fármacos'': Suspender agente causal</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* <del class="diffchange diffchange-inline">'</del>''Neurológica/quirúrgica<del class="diffchange diffchange-inline">'</del>'': &#160;</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* ''Neurológica/quirúrgica'': &#160;</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">&#160; </del>* Manejo neuroprotector (ej. hiperventilación en hipertensión intracraneal)</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">*</ins>* Manejo neuroprotector (ej. hiperventilación en hipertensión intracraneal)</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">&#160; </del>* Cirugía descompresiva en hernias cerebrales</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">*</ins>* Cirugía descompresiva en hernias cerebrales</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* <del class="diffchange diffchange-inline">'</del>''Sintomático<del class="diffchange diffchange-inline">'</del>'': &#160;</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* ''Sintomático'': &#160;</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">&#160; </del>* Gafas con filtros UV para fotofobia</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">*</ins>* Gafas con filtros UV para fotofobia</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">&#160; </del>* Pilocarpina tópica al 0.5-1% en casos severos</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">*</ins>* Pilocarpina tópica al 0.5-1% en casos severos</div></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Complicaciones potenciales ==</div></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Complicaciones potenciales ==</div></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* <del class="diffchange diffchange-inline">'</del>''Fototoxicidad retiniana<del class="diffchange diffchange-inline">'</del>'' por exposición lumínica prolongada</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*''Fototoxicidad retiniana'' por exposición lumínica prolongada</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* <del class="diffchange diffchange-inline">'</del>''Déficit de acomodación<del class="diffchange diffchange-inline">'</del>'' persistente</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*''Déficit de acomodación'' persistente</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* <del class="diffchange diffchange-inline">'</del>''Glaucoma agudo<del class="diffchange diffchange-inline">'</del>'' en ojos con cámara anterior estrecha</div></td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*''Glaucoma agudo'' en ojos con cámara anterior estrecha</div></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Prevención ==</div></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>== Prevención ==</div></td></tr> <!-- diff cache key wiki1:diff::1.12:old-4583146:rev-4583147 --> </table>

JorgeG Gt https://www.ecured.cu/index.php?title=Midriasis&diff=4583146&oldid=prev 2025-06-12T19:24:17Z

<p></p> <table class="diff diff-contentalign-left" data-mw="interface"> <col class="diff-marker" /> <col class="diff-content" /> <col class="diff-marker" /> <col class="diff-content" /> <tr class="diff-title" lang="es"> <td colspan="2" style="background-color: #fff; color: #222; text-align: center;">← Revisión anterior</td> <td colspan="2" style="background-color: #fff; color: #222; text-align: center;">Revisión del 19:24 12 jun 2025</td> </tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l1" >Línea 1:</td> <td colspan="2" class="diff-lineno">Línea 1:</td></tr> <tr><td colspan="2">&#160;</td><td class='diff-marker'>+</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">{{Sistema:Moderación Salud}}</ins></div></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>{{Enfermedad</div></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>{{Enfermedad</div></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>|nombre = Midriasis</div></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>|nombre = Midriasis</div></td></tr> <tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l8" >Línea 8:</td> <td colspan="2" class="diff-lineno">Línea 9:</td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>|CIE-10 = H57.04</div></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>|CIE-10 = H57.04</div></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>}}</div></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>}}</div></td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"></del></div></td><td colspan="2">&#160;</td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;">== Definición ==</del></div></td><td colspan="2">&#160;</td></tr> <tr><td class='diff-marker'>−</td><td style="color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"></del></div></td><td colspan="2">&#160;</td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>La '''midriasis''' es la dilatación anormal o excesiva de la [[pupila]], con un diámetro superior a 5 mm en condiciones de iluminación normal. Representa el estado contrario a la [[miosis]] (contracción pupilar).</div></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>La '''midriasis''' es la dilatación anormal o excesiva de la [[pupila]], con un diámetro superior a 5 mm en condiciones de iluminación normal. Representa el estado contrario a la [[miosis]] (contracción pupilar).</div></td></tr> <tr><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'>&#160;</td><td style="background-color: #f8f9fa; color: #222; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"></td></tr> <!-- diff cache key wiki1:diff::1.12:old-4583100:rev-4583146 --> </table>

JorgeG Gt https://www.ecured.cu/index.php?title=Midriasis&diff=4583100&oldid=prev 2025-06-12T18:05:20Z

<p>Página creada con «{{Enfermedad |nombre = Midriasis |imagen = Midriasis-ocular.jpg |pie_imagen = Pupilas dilatadas (&gt;5mm) en condición de luz normal |tamaño_imagen = 250px |campo = Oftalmol…»</p> <p><b>Página nueva</b></p><div>{{Enfermedad<br /> |nombre = Midriasis<br /> |imagen = Midriasis-ocular.jpg<br /> |pie_imagen = Pupilas dilatadas (&gt;5mm) en condición de luz normal<br /> |tamaño_imagen = 250px<br /> |campo = Oftalmología, Neurología<br /> |sinónimos = Pupilas dilatadas, Miosis inversa<br /> |CIE-10 = H57.04<br /> }}<br /> <br /> == Definición ==<br /> <br /> La '''midriasis''' es la dilatación anormal o excesiva de la [[pupila]], con un diámetro superior a 5 mm en condiciones de iluminación normal. Representa el estado contrario a la [[miosis]] (contracción pupilar).<br /> <br /> == Mecanismo fisiológico ==<br /> <br /> * '''Activación simpática''': Estimula el músculo dilatador del iris (vía cadena cervical)<br /> * '''Inhibición parasimpática''': Reduce la acción del esfínter pupilar (nervio oculomotor)<br /> * '''Balance neuroquímico''': Predominio de noradrenalina sobre acetilcolina<br /> <br /> == Clasificación etiológica ==<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! Tipo<br /> ! Causas principales<br /> |-<br /> | '''Fisiológica'''<br /> | Oscuridad, estrés emocional, jóvenes (&lt;25 años)<br /> |-<br /> | '''Farmacológica'''<br /> | Atropina, antihistamínicos, antidepresivos tricíclicos<br /> |-<br /> | '''Traumática'''<br /> | Contusión ocular, traumatismo craneoencefálico<br /> |-<br /> | '''Neurológica'''<br /> | Hernia cerebral, accidente cerebrovascular, epilepsia<br /> |-<br /> | '''Oftalmológica'''<br /> | Glaucoma agudo, parálisis del III par craneal<br /> |}<br /> <br /> == Manifestaciones clínicas ==<br /> <br /> * '''Síntomas frecuentes''':<br /> * Fotofobia (sensibilidad a la luz)<br /> * Visión borrosa (especialmente en cerca)<br /> * Deslumbramiento nocturno<br /> * '''Signos asociados''':<br /> * Pupilas &gt;5mm no reactivas a la luz<br /> * Anisocoria (asimetría pupilar) en causas unilaterales<br /> <br /> == Diagnóstico diferencial ==<br /> <br /> * '''Midriasis benigna''': Variante anatómica normal<br /> * '''Síndrome de Adie''': Pupila tónica + hiporreflexia<br /> * '''Parálisis del III par''': Ptosis + oftalmoplejía asociada<br /> <br /> == Protocolo de evaluación ==<br /> <br /> 1. '''Historia clínica''': Uso de fármacos, traumatismos, síntomas neurológicos<br /> 2. '''Examen pupilar''':<br /> * Reactividad a luz (directa y consensual)<br /> * Prueba de acomodación-convergencia<br /> 3. '''Pruebas complementarias''':<br /> * TAC/RM cerebral si sospecha neurológica<br /> * Tonometría para descartar glaucoma<br /> <br /> == Abordaje terapéutico ==<br /> <br /> * '''Midriasis fisiológica''': No requiere tratamiento<br /> * '''Inducida por fármacos''': Suspender agente causal<br /> * '''Neurológica/quirúrgica''': <br /> * Manejo neuroprotector (ej. hiperventilación en hipertensión intracraneal)<br /> * Cirugía descompresiva en hernias cerebrales<br /> * '''Sintomático''': <br /> * Gafas con filtros UV para fotofobia<br /> * Pilocarpina tópica al 0.5-1% en casos severos<br /> <br /> == Complicaciones potenciales ==<br /> <br /> * '''Fototoxicidad retiniana''' por exposición lumínica prolongada<br /> * '''Déficit de acomodación''' persistente<br /> * '''Glaucoma agudo''' en ojos con cámara anterior estrecha<br /> <br /> == Prevención ==<br /> <br /> * Control oftalmológico anual si uso crónico de midriáticos<br /> * Protección ocular en actividades de riesgo traumático<br /> * Educación sobre efectos secundarios de fármacos anticolinérgicos<br /> <br /> == Referencias ==<br /> <br /> *https://www.clinicagonzalezcostea.es/midriasis/<br /> *https://www.aao.org/salud-ocular/consejos/preocupado-por-las-pupilas-dilatadas-causas-y-trat<br /> *https://www.oftalvist.es/blog/pupilas-dilatadas-midriasis<br /> *https://www.aao.org/salud-ocular/consejos/pupilas-dilatadas<br /> * AAO (2023). ''Guía de trastornos pupilares''.<br /> * Oftalvist (2022). ''Urgencias en neurooftalmología''.<br /> * Clínica González Costea (2021). ''Manual de semiología pupilar''.<br /> <br /> <br /> [[Categoría:Trastornos de la pupila]] <br /> [[Categoría:Urgencias oftalmológicas]] <br /> [[Categoría:Efectos adversos farmacológicos]]</div>

Gustavo núñez