View source for Medicine:Miosis

{{short description|Excessive constriction of the pupil}}
{{Infobox medical condition (new)
| name          = 
| synonyms      = Myosis, pinpoint pupil
| pronounce     = {{IPAc-en|m|aɪ|ˈ|oʊ|s|ɪ|s}}
| image         = Human eye in bright light.jpg
| caption       = Miosis from bright light pointed directly at the eye. Pupil measured 2.3 mm in diameter
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| symptoms      = Constricted pupils
| complications = 
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'''Miosis''', or '''myosis''' ({{ety|grc|''{{wikt-lang|grc|μύειν}}'' ({{grc-transl|μύειν}})|to close the eyes}}), is excessive [[Biology:Pupillary response|constriction of the pupil]].<ref>[http://medical-dictionary.thefreedictionary.com/miosis Farlex medical dictionary] citing:
* Miller-Keane Encyclopedia & Dictionary of Medicine, Nursing, and Allied Health, 7th ed.
* Saunders Comprehensive Veterinary Dictionary, 3rd ed.</ref><ref>{{cite book |vauthors=Seidel HM, Ball JW, Dains JE, Benedict GW |title=Mosby's Guide to Physical Examination |publisher=Mosby |isbn=978-0-323-03573-6 |date=2006-03-29 |url-access=registration |url=https://archive.org/details/mosbysguidetophy0000unse_i9g4}}</ref><ref>[http://medical-dictionary.thefreedictionary.com/miosis Farlex medical dictionary] citing: Millodot: Dictionary of Optometry and Visual Science, 7th ed.</ref><ref>[http://medical-dictionary.thefreedictionary.com/miosis Farlex medical dictionary] citing: Mosby's Medical Dictionary, 8th ed.</ref> The opposite condition, [[Medicine:Mydriasis|mydriasis]], is the [[Biology:Pupillary response|dilation of the pupil]]. [[Medicine:Anisocoria|Anisocoria]] is the condition of one [[Biology:Pupil|pupil]] being more dilated than the other.

==Causes==

=== Age ===
* Senile miosis (a reduction in the size of a person's pupil in old age)

=== Diseases ===
* Ehlers Danlos Syndrome
* [[Medicine:Horner's syndrome|Horner's syndrome]]
* Hemorrhage into [[Biology:Pons|pons]] ([[Medicine:Intracranial hemorrhage|intracranial hemorrhage]])
* Hereditary disorders  
* Cluster headaches with ptosis
* Iridocyclitis
* Fatal familial insomnia
* Aphakia
[[File:Miosis caused by opium consumption.jpg|thumb|300x300px|Miosis caused by high doses of opiates. Patient also shows ptosis of both eyelids and an inattentive look at the camera, a sign of altered level of consciousness caused by the sedative effect of the drug.]]

=== Drugs ===
* [[Chemistry:Opioid|Opioid]]s such as [[Chemistry:Fentanyl|fentanyl]], [[Biology:Morphine|morphine]], [[Chemistry:Heroin|heroin]] and [[Chemistry:Methadone|methadone]] (the notable exception being [[Chemistry:Pethidine|pethidine]])
* Products containing [[Chemistry:Nicotine|nicotine]] such as cigarettes, chewing tobacco or gum.
* [[Chemistry:Imidazoline|Imidazoline]]s such as [[Chemistry:Clonidine|clonidine]], [[Chemistry:Naphazoline|naphazoline]], [[Chemistry:Oxymetazoline|oxymetazoline]] and tetrahydrozoline
* Antipsychotics, including [[Chemistry:Risperidone|risperidone]], [[Chemistry:Haloperidol|haloperidol]], [[Chemistry:Chlorpromazine|chlorpromazine]], [[Chemistry:Olanzapine|olanzapine]], [[Chemistry:Quetiapine|quetiapine]]<ref name="Merck_Manual_Amphetamines">{{cite journal | vauthors = Hou RH, Scaife J, Freeman C, Langley RW, Szabadi E, Bradshaw CM | title = Relationship between sedation and pupillary function: comparison of diazepam and diphenhydramine | journal = British Journal of Clinical Pharmacology | volume = 61 | issue = 6 | pages = 752–60 | date = June 2006 | pmid = 16722841 | pmc = 1885114 | doi = 10.1111/j.1365-2125.2006.02632.x }}</ref>
* [[Biology:Cholinergic|Cholinergic]] agents such as [[Chemistry:Acetylcholine|acetylcholine]]  
* [[Biology:Acetylcholinesterase inhibitor|Acetylcholinesterase inhibitors]]
* Serotonin antagonists, such as [[Chemistry:Ondansetron|Ondansetron]] (an anti-emetic) known by its brand name Zofran
* Some cancer [[Medicine:Chemotherapy|chemotherapy]] drugs, including [[Biology:Camptothecin|camptothecin]] derivatives
* [[Chemistry:Mirtazapine|Mirtazapine]], a [[Chemistry:Noradrenergic and specific serotonergic antidepressant|noradrenergic and specific serotonergic antidepressant]] (NaSSA)
* Some MAO Inhibitors.
* [[Chemistry:Pilocarpine|Pilocarpine]] eye drops and all other parasympathomimetics
* In some rare cases, when exposed to [[Chemistry:Mustard gas|mustard gas]]
* Organophosphates

==Physiology of the photomotor reflex==
Light entering the eye strikes three different [[Biology:Photoreceptor cell|photoreceptor]]s in the [[Biology:Retina|retina]]: the familiar [[Biology:Rod cell|rods]] and [[Biology:Cone cell|cones]] used in image forming and the more newly discovered photosensitive ganglion cells.  The ganglion cells give information about ambient light levels, and react sluggishly compared to the rods and cones.  Signals from photosensitive ganglion cells have multiple functions including acute suppression of the hormone [[Chemistry:Melatonin|melatonin]], entrainment of the body's [[Biology:Circadian rhythm|circadian rhythm]]s and regulation of the size of the pupil.

The retinal photoceptors convert light stimuli into electric impulses.  Nerves involved in the resizing of the pupil connect to the pretectal nucleus of the high midbrain, bypassing the [[Biology:Lateral geniculate nucleus|lateral geniculate nucleus]] and the primary [[Biology:Visual cortex|visual cortex]]. From the pretectal nucleus neurons send axons to neurons of the Edinger-Westphal nucleus whose visceromotor axons run along both the left and right [[Biology:Oculomotor nerve|oculomotor nerve]]s. Visceromotor nerve axons (which constitute a portion of cranial nerve III, along with the somatomotor portion derived from the Edinger-Westphal nucleus) synapse on ciliary ganglion neurons, whose parasympathetic axons innervate the [[Biology:Iris sphincter muscle|iris sphincter muscle]], producing '''miosis'''.

== See also ==
{{col div|colwidth=40em}}
* [[Medicine:Adie syndrome|Adie syndrome]]
* [[Medicine:Argyll Robertson pupil|Argyll Robertson pupil]]
* [[Medicine:Cycloplegia|Cycloplegia]]
* [[Medicine:Glaucoma|Glaucoma]]
* Marcus Gunn pupil
* [[Medicine:Parinaud's syndrome|Parinaud's syndrome]]
* [[Biology:Pupillary light reflex|Pupillary light reflex]]
* [[Medicine:Syphilis|Syphilis]]
{{colend}}

== References ==
{{reflist}}

== External links ==
{{Medical resources
| DiseasesDB      = 8243
| ICD10           = {{ICD10|H|57|0|h55}}
| ICD9            = {{ICD9|379.42}}
| ICDO            = 
| OMIM            = 
| MedlinePlus     = 
| eMedicineSubj   = 
| eMedicineTopic  = 
| MeshID          = D015877
| ICD10CM         = {{ICD10CM|H57.03}}
}}
* [https://web.archive.org/web/20051124044807/http://www.fpnotebook.com/EYE35.htm FP Notebook]

{{Antiglaucoma preparations and miotics}}
{{Eye pathology}}

[[Category:Medical signs]]
[[Category:Ophthalmology]]

{{Sourceattribution|Miosis}}