approach to a fixed dilated pupil

I'm an OD working in a busy, pathology-heavy ophthalmology clinic. Recently, I've had 2 patients come in with a blown-out, non reactive pupil. Both were women in their 40s with no other symptoms. Neither had any ptosis, diplopia, or headache. Denied any eyedrops or new meds. Neither were diabetic or had any ischemic risk factors for a 3rd nerve palsy. I know these cases are almost always pharmacologic, but I usually consult with an MD because I don't want to waste the patient's time or money on unnecessary imaging, but I also don't want to send them home assuming it is pharmacologic and have them drop dead from an aneurysm.

In one case, the MD (in practice for 5+ years) sent the patient to the ER for an MRI. He said that even though there was no obvious muscle palsy, there could be a compressive lesion only affecting the pupil fibers of the 3rd nerve.

In the other case, the MD (40+ years in practice) said she had simply come into contact with something on her hands, then touched her eye and it caused the dilation. That the ER was a waste of time. Told her it would go back to normal and sent her on her way.

Experience surely counts for a lot. Do you think the younger MD is overly cautious? Or is the older one too cavalier?

There are certain days where I'm the only provider in the office and there are no MDs with which to consult. Just wanted to see how the MDs here would approach this, or how you would recommend an OD flying solo to approach it. Thanks!