23rd August 2024

A 24-year-old female with a background of recurrent migraines goes to her optician for a routine eye check-up

A 24-year-old female with a background of recurrent migraines goes to her optician for a routine eye check-up. The optician notes that one of her pupils is larger than the other and is slow to react to light. He refers her to the general neurology clinic for further evaluation.

There are no abnormal findings on eye movement, acuity or on fundoscopy. Her neurological examination is otherwise unremarkable.

Which of the following explains her pupillary findings?

Select the SINGLE most appropriate option from the list below. Select ONE option only.