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BMJ. 2008 January 5; 336(7634): 52.
PMCID: PMC2174769
Linda Williams, senior house officer, Vikram Sharma, specialist registrar, and Tom Downes, consultant physician

A 43 year old woman with a known pituitary adenoma presented as an emergency with a dilated pupil.pupil. An urgent magnetic resonance scan showed no acute change. The patient made the diagnosis by “phoning a friend”—a dermatology nurse. She was reminded to mention the prescription hand cream she occasionally used. It was glycopyrollate solution, an antimuscarinic medication for hyperhydrosis. She had accidentally wiped some around her eye the previous night. She made a full recovery.

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