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Allan J. Flach, MD; Marilyn E. Donahue
San Francisco, Calif

Arch Ophthalmol. 1995;113(4):403-404.

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We appreciate Dr Apt's interest in our report of a case of transient anisocoria related to flea collar contact. Furthermore, we found the brief note by Ellenberg et al¹ interesting. Although we agree that their report probably represents a case of flea collar-induced anisocoria, the patient described within that report was also hit in the head with a hammer directly prior to the onset of the observed anisocoria. Therefore, the possibility of transient traumatic mydriasis exists. In addition, the diagnosis was based entirely on the patient's history because she was not actually examined at the time of the anisocoria.

Although the flea collar in the report by Ellenberg et al is described as containing a carbamate derivative with anticholinesterase properties, we cannot assume all such chemically related agents have the proper solubility characteristics to penetrate an intact cornea and exert pharmacologic effects. For example, carbachol is a . . . [Full Text PDF of this Article]

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