To the Editor: The unilateral fixed, dilated pupil receives an inordinate amount of attention as a possible harbinger of neurologic catastrophe. Consequently, I was intrigued by Dr. Chiaramonte's letter in the January 21 issue,1 in which he reported unilateral mydriasis on the same side as the placement of an antiemetic Transderm disk, which delivers scopolamine to the plasma after saturating skin-binding sites. Clearly, systemically administered scopolamine should not cause an isolated, nonreactive mydriasis, which is more typically seen in Adie's pupil, traumatic iridoplegia, glaucoma, ocular ischemia, and extremely rarely, in oculomotor-nerve or mesencephalic lesions. Although I have observed bilateral mydriasis.
All Science Journal Classification (ASJC) codes