Miosis
Encyclopedia
Miosis is the constriction
of the pupil
of the eye
to two millimeters or less. The pupillary response
(enlargement or reduction of the pupil) is a normal response to changes in light levels, but changes in pupil size can also be associated with certain pathological conditions
, microwave
radiation exposure
, and certain drug
s, especially opioids. Parasympathetic
stimulation of the iris sphincter muscle
(pupillary sphincter muscle) decreases the pupillary aperture (size of the pupil). This constriction is referred to as miosis.
The opposite condition, mydriasis
, is the dilation of the pupil.
s in the retina
: the familiar rods
and cones
used in image forming and the more newly discovered photosensitive ganglion cell
s. The ganglion cells give information about ambient light levels, and react sluggishly compared to the rods and cones. Signals from ganglion cells have three functions: acute suppression of the hormone melatonin
, entrainment
of the body's 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 lateral geniculate nucleus
and the primary 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 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 iris sphincter muscle, producing miosis. This occurs because sympathetic activity from the ciliary ganglion is lost thus parasympathetics are not inhibited.
Image
of the eye (or miosis). It is the opposite of a mydriatic substance, which causes dilation of the pupil.
Constriction
Constriction is a method used by various snake species to kill their prey. Although some species of venomous and mildly-venomous snakes do use constriction to subdue their prey, most snakes which use constriction lack venom. The snake initially strikes at its prey and holds on, pulling the prey...
of the pupil
Pupil
The pupil is a hole located in the center of the iris of the eye that allows light to enter the retina. It appears black because most of the light entering the pupil is absorbed by the tissues inside the eye. In humans the pupil is round, but other species, such as some cats, have slit pupils. In...
of the eye
Human eye
The human eye is an organ which reacts to light for several purposes. As a conscious sense organ, the eye allows vision. Rod and cone cells in the retina allow conscious light perception and vision including color differentiation and the perception of depth...
to two millimeters or less. The pupillary response
Pupillary response
Pupillary response or dilation of the pupil is a physiological response that varies the size of the pupil of the eye via the iris dilator muscle...
(enlargement or reduction of the pupil) is a normal response to changes in light levels, but changes in pupil size can also be associated with certain pathological conditions
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
, microwave
Microwave
Microwaves, a subset of radio waves, have wavelengths ranging from as long as one meter to as short as one millimeter, or equivalently, with frequencies between 300 MHz and 300 GHz. This broad definition includes both UHF and EHF , and various sources use different boundaries...
radiation exposure
Radiation exposure
The term radiation exposure commonly has several uses:* Absorption of high-energy ionizing radiation by an object. In living beings a high absorbed dose can lead to radiation poisoning.* Absorption by an object of non-ionizing radiation...
, and certain drug
Drug
A drug, broadly speaking, is any substance that, when absorbed into the body of a living organism, alters normal bodily function. There is no single, precise definition, as there are different meanings in drug control law, government regulations, medicine, and colloquial usage.In pharmacology, a...
s, especially opioids. Parasympathetic
Parasympathetic nervous system
The parasympathetic nervous system is one of the two main divisions of the autonomic nervous system . The ANS is responsible for regulation of internal organs and glands, which occurs unconsciously...
stimulation of the iris sphincter muscle
Iris sphincter muscle
The iris sphincter muscle is a muscle in the part of the eye called the iris...
(pupillary sphincter muscle) decreases the pupillary aperture (size of the pupil). This constriction is referred to as miosis.
The opposite condition, mydriasis
Mydriasis
Mydriasis is a dilation of the pupil due to disease, trauma or the use of drugs. Normally, the pupil dilates in the dark and constricts in the light to respectively improve vividity at night and to protect the retina from sunlight damage during the day...
, is the dilation of the pupil.
Physiology of the photomotor reflex
Light entering the eye strikes three different photoreceptorPhotoreceptor
A photoreceptor cell is a specialized type of neuron found in the eye's retina that is capable of phototransduction. The great biological importance of photoreceptors is that they convert light into signals that can stimulate biological processes...
s in the retina
Retina
The vertebrate retina is a light-sensitive tissue lining the inner surface of the eye. The optics of the eye create an image of the visual world on the retina, which serves much the same function as the film in a camera. Light striking the retina initiates a cascade of chemical and electrical...
: the familiar rods
Rod cell
Rod cells, or rods, are photoreceptor cells in the retina of the eye that can function in less intense light than can the other type of visual photoreceptor, cone cells. Named for their cylindrical shape, rods are concentrated at the outer edges of the retina and are used in peripheral vision. On...
and cones
Cone cell
Cone cells, or cones, are photoreceptor cells in the retina of the eye that are responsible for color vision; they function best in relatively bright light, as opposed to rod cells that work better in dim light. If the retina is exposed to an intense visual stimulus, a negative afterimage will be...
used in image forming and the more newly discovered photosensitive ganglion cell
Photosensitive ganglion cell
Photosensitive ganglion cells, also called photosensitive Retinal Ganglion Cells , intrinsically photosensitive Retinal Ganglion Cells or melanopsin-containing ganglion cells, are a type of neuron in the retina of the mammalian eye.They were discovered in the early 1990sand are, unlike other...
s. The ganglion cells give information about ambient light levels, and react sluggishly compared to the rods and cones. Signals from ganglion cells have three functions: acute suppression of the hormone melatonin
Melatonin
Melatonin , also known chemically as N-acetyl-5-methoxytryptamine, is a naturally occurring compound found in animals, plants, and microbes...
, entrainment
Entrainment (chronobiology)
Entrainment, within the study of chronobiology, occurs when rhythmic physiological or behavioral events match their period and phase to that of an environmental oscillation. A common example is the entrainment of circadian rhythms to the daily light–dark cycle, which ultimately is determined by...
of the body's circadian rhythm
Circadian rhythm
A circadian rhythm, popularly referred to as body clock, is an endogenously driven , roughly 24-hour cycle in biochemical, physiological, or behavioural processes. Circadian rhythms have been widely observed in plants, animals, fungi and cyanobacteria...
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
Pretectum
The pretectum, also known as the pretectal area, is a region of neurons found between the thalamus and midbrain. It receives binocular sensory input from retinal ganglion cells of the eyes, and is the region responsible for maintaining the pupillary light reflex.-Outputs:The pretectum, after...
of the high midbrain
Mesencephalon
The midbrain or mesencephalon is a portion of the central nervous system associated with vision, hearing, motor control, sleep/wake, arousal , and temperature regulation....
, bypassing the lateral geniculate nucleus
Lateral geniculate nucleus
The lateral geniculate nucleus is the primary relay center for visual information received from the retina of the eye. The LGN is found inside the thalamus of the brain....
and the primary visual cortex
Visual cortex
The visual cortex of the brain is the part of the cerebral cortex responsible for processing visual information. It is located in the occipital lobe, in the back of the brain....
. From the pretectal nucleus neurons send axons to neurons of the Edinger-Westphal nucleus
Edinger-Westphal nucleus
The Edinger-Westphal nucleus is the accessory parasympathetic cranial nerve nucleus of the oculomotor nerve , supplying the constricting muscles of the iris...
whose visceromotor
Motor neuron
In vertebrates, the term motor neuron classically applies to neurons located in the central nervous system that project their axons outside the CNS and directly or indirectly control muscles...
axons run along both the left and right oculomotor nerve
Oculomotor nerve
The oculomotor nerve is the 3rd of 12 paired cranial nerves. It enters the orbit via the superior orbital fissure and controls most of the eye's movements, including constriction of the pupil and maintaining an open eyelid by innervating the Levator palpebrae superiors muscle. The optic nerve is...
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
Ciliary ganglion
The ciliary ganglion is a parasympathetic ganglion located in the posterior orbit. It measures 1–2 millimeters in diameter and contains approximately 2,500 neurons. Preganglionic axons from the Edinger-Westphal nucleus travel along the oculomotor nerve and form synapses with these cells...
neurons, whose parasympathetic axons innervate the iris sphincter muscle, producing miosis. This occurs because sympathetic activity from the ciliary ganglion is lost thus parasympathetics are not inhibited.
Image
Diseases
- Horner syndrome (a set of abnormalities in the nervous supply of the face due to damage to the sympathetic nervous systemSympathetic nervous systemThe sympathetic nervous system is one of the three parts of the autonomic nervous system, along with the enteric and parasympathetic systems. Its general action is to mobilize the body's nervous system fight-or-flight response...
). - Hemorrhage into ponsPonsThe pons is a structure located on the brain stem, named after the Latin word for "bridge" or the 16th-century Italian anatomist and surgeon Costanzo Varolio . It is superior to the medulla oblongata, inferior to the midbrain, and ventral to the cerebellum. In humans and other bipeds this means it...
(intracranial hemorrhageIntracranial hemorrhageAn intracranial hemorrhage is a hemorrhage, or bleeding, within the skull.-Causes:Intracranial bleeding occurs when a blood vessel within the skull is ruptured or leaks. It can result from physical trauma or nontraumatic causes such as a ruptured aneurysm...
) - Cluster Headaches with ptosisPtosis (eyelid)Ptosis is a drooping of the upper or lower eyelid. The drooping may be worse after being awake longer, when the individual's muscles are tired. This condition is sometimes called "lazy eye", but that term normally refers to amblyopia...
- IridocyclitisIridocyclitisIridocyclitis, a type of anterior uveitis, is a condition in which the uvea of the eye is inflamed.Iridocyclitis isInflammation of the iris and the ciliary body.- Symptoms :Symptoms include:* Photophobia* Redness* Watering of the eyes* Lacrimation...
- Fatal familial insomniaFatal familial insomniaFatal familial insomnia is a very rare autosomal dominant inherited prion disease of the brain. It is almost always caused by a mutation to the protein PrPC, but can also develop spontaneously in patients with a non-inherited mutation variant called sporadic fatal insomnia...
Drugs
- OpioidOpioidAn opioid is a psychoactive chemical that works by binding to opioid receptors, which are found principally in the central and peripheral nervous system and the gastrointestinal tract...
s such as fentanyl, morphineMorphineMorphine is a potent opiate analgesic medication and is considered to be the prototypical opioid. It was first isolated in 1804 by Friedrich Sertürner, first distributed by same in 1817, and first commercially sold by Merck in 1827, which at the time was a single small chemists' shop. It was more...
, heroin and methadoneMethadoneMethadone is a synthetic opioid, used medically as an analgesic and a maintenance anti-addictive for use in patients with opioid dependency. It was developed in Germany in 1937...
(the notable exception being demerol) - Antipsychotics, including haloperidolHaloperidolHaloperidol is a typical antipsychotic. It is in the butyrophenone class of antipsychotic medications and has pharmacological effects similar to the phenothiazines....
, thorazine, olanzapineOlanzapineOlanzapine is an atypical antipsychotic, approved by the FDA for the treatment of schizophrenia and bipolar disorder...
, quetiapineQuetiapineQuetiapine , is an atypical antipsychotic approved for the treatment of schizophrenia, and bipolar disorder....
and others - CholinergicCholinergicThe word choline generally refers to the various quaternary ammonium salts containing the N,N,N-trimethylethanolammonium cation. Found in most animal tissues, choline is a primary component of the neurotransmitter acetylcholine and functions with inositol as a basic constituent of lecithin...
agents such as acetylcholineAcetylcholineThe chemical compound acetylcholine is a neurotransmitter in both the peripheral nervous system and central nervous system in many organisms including humans... - Some cancer chemotherapyChemotherapyChemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....
drugs, including camptothecinCamptothecinCamptothecin is a cytotoxic quinoline alkaloid which inhibits the DNA enzyme topoisomerase I . It was discovered in 1966 by M. E. Wall and M. C. Wani in systematic screening of natural products for anticancer drugs. It was isolated from the bark and stem of Camptotheca acuminata , a tree native to...
derivatives - MirtazapineMirtazapineMirtazapine is a tetracyclic antidepressant used primarily in the treatment of depression. It is also sometimes used as a hypnotic, antiemetic, and appetite stimulant, and for the treatment of anxiety, among other indications...
, a noradrenergic and specific serotonergic antidepressantNoradrenergic and specific serotonergic antidepressantNoradrenergic and specific serotonergic antidepressants are a class of psychiatric drugs used primarily as antidepressants. They act by antagonizing various adrenergic and serotonin receptors, of which typically consist of α1-adrenergic and α2-adrenergic, and 5-HT2A, 5-HT2C, and 5-HT3, respectively...
(NaSSA) - TrazodoneTrazodoneTrazodone is an antidepressant of the serotonin antagonist and reuptake inhibitor class. It is a phenylpiperazine compound...
- Some MAO Inhibitors.
- In some rare cases, when exposed to mustard gas.
- Organophosphates
Miotics
A miotic substance causes the constriction of the pupilPupil
The pupil is a hole located in the center of the iris of the eye that allows light to enter the retina. It appears black because most of the light entering the pupil is absorbed by the tissues inside the eye. In humans the pupil is round, but other species, such as some cats, have slit pupils. In...
of the eye (or miosis). It is the opposite of a mydriatic substance, which causes dilation of the pupil.
See also
- Adie syndromeAdie syndromeAdie syndrome, sometimes known as Holmes-Adie's syndrome or Adie's Tonic Pupil, is a neurological disorder characterized by a tonically dilated pupil. It is named after the British neurologist William John Adie...
- AnisocoriaAnisocoria-Causes:In the absence of the iris or eyeball proper, anisocoria is usually the result of a defect in efferent nervous pathways controlling the pupil traveling in the oculomotor nerve or the sympathetic pathways...
- CycloplegiaCycloplegiaCycloplegia is paralysis of the ciliary muscle of the eye, resulting in a loss of accommodation.-Anatomy:The iris is the heavily pigmented colored part of the eye. It has a contractile diaphragm in front of the lens with a central opening called the pupil...
- Marcus Gunn pupilMarcus Gunn pupilMarcus Gunn pupil is a medical sign observed during the swinging-flashlight test whereupon the patient's pupils constrict less when a bright light is swung from the unaffected eye to the affected eye...
- MydriasisMydriasisMydriasis is a dilation of the pupil due to disease, trauma or the use of drugs. Normally, the pupil dilates in the dark and constricts in the light to respectively improve vividity at night and to protect the retina from sunlight damage during the day...
- Parinaud's syndromeParinaud's syndromeParinaud's Syndrome, also known as dorsal midbrain syndrome is a group of abnormalities of eye movement and pupil dysfunction. It is caused by lesions of the upper brain stem and is named for Henri Parinaud , considered to be the father of French ophthalmology...
- SyphilisSyphilisSyphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...