Anisocoria From Jimsonweed

To the Editor.— The original article by Price 1 and the recent exchange of letters in JAMA concerning anisocoria from scopolamine patches emphasize an interesting addition to the differential diagnosis of a fixed and dilated pupil. We report a similar case in which we identified an isolated peripheral anticholinergic effect from local contact with jimsonweed. The jimsonweed plant, Datura stramonium , grows wild throughout the United States, and ingestion of any part of the plant produces a characteristic syndrome of systemic anticholinergic poisoning. 2 Report of a Case.— A 38-year-old man presented to the emergency department complaining of blurred vision and a dilated pupil. He had spent the morning trimming weeds with a mechanical weed trimmer. He felt otherwise normal and specifically denied headache, nausea, or a stiff neck. His mental status was normal. The right pupil was fully dilated at 6 mm and nonreactive to light, while the left pupil was