Comparative Neuro-Ophthalmology - North Carolina State ...

Pharmacologic Testing withParasympathetic Denervation• hypersensitivity > with ganglionic or postganglionic lesions• pharmacologic testing distinguishes from atropine blockade oriridal disease (atrophy, synechia) and aids in lesion localization:- 0.5% physostigmine (indirect parasympathomimetic, allows buildup ofacetylcholine at synaptic fissure):• postganglionic = no constriction• central/preganglionic = rapid constriction before normal, control eye- 2% pilocarpine (direct parasympathomimetic):• 24 hours post indirect agent testing• confirms lesion is neurologic• postganglionic lesion constricts sooner than normal eye