nebulized ipratropium bromide-induced anisocoria: why is anisocoria observed?

Pharmacological anisocoria is a rare but benign condition. this paper presents an eleven-yearold patient with asthma who developed ipratropium bromide-associated anisocoria during nebulizer treatment. hypotheses regarding the possible causes of anisocoria are discussed and precautions to be taken during treatment are presented. to prevent the development of anisocoria, it was found that it is important to use the appropriate mask during nebulizer treatment, to place the mask on the face properly, and, if possible, to administer drugs by closing the eyes. further, it is recommended that patients undergo an ophthalmological examination before discharge and that they and their families be informed that the condition is temporary.