A 7-year-old girl presented with bilaterally dilated pupils, nausea, and vomiting 2 days after head trauma. Pilocarpine pupil testing led to the correct diagnosis of pharmacologic pupillary dilation from an unexpected and unusual source of plant poisoning, Solanum dulcamara (blue nightshade). In
Uni- or bilateral dilatation of pupils that are not reactive to light and lack miosis in response to 1% pilocarpine may be caused by contact with plants containing alkaloids such as scopolamine and atropine. Other causes of a non-light-reactive dilated pupil, such as Adie's tonic pupil, third nerve