Observation: 4

---

You are asked to carry out pupillary examination on this  patient. Observation reveals this appearance. What can you see? Answer Anisocoria with the right pupil being bigger. Heterochromia iridis with the right iris being of  darker colour than the left. What is the most likely diagnosis? Answer Although the anisocoria and heterochromia iridis  may be caused by two separate pathologies.  In this case, we are looking for a condition that  can cause these two signs. The most likely diagnosis is therefore siderosis bulbi. What signs may be present during pupillary examination? Answer Absent response to light and accommodation. Return to observation