Didatic case: gardener's eye.

Ocular examination was normal except for internal ophthalmoplegia of the left eye. The left pupil did not constrict when pilocarpine drops of either 0.125% or 1% were applied to the eye suggesting pharmacological origin of the condition and excluding an Adie’s pupil and a third nerve palsy respectively. A detailed medical history helped to the final diagnosis of pharmacological mydriasis by revealing his work as a gardener and the exposure to a toxic botanical (Datura plant) (figure 2). This ornamental plant is frequently found in western Europe gardens due its fragrance and Beauty (1). It contains large quantities of scopolamine and traces of atropine (2). The patient was discharged and the mydriasis disappeared during the next 36 hours (figure 1b). Thus, detailed inquiry can help to avoid unnecessary and expensive imaging to rule out underlying neurological disorder when evaluating fixed dilated pupil.