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The usual treatment of a standardised Adie syndrome is to prescribe reading glasses to correct for impairment of the eye(s). [1] Pilocarpine drops may be administered as a treatment as well as a diagnostic measure. [1] Thoracic sympathectomy is the definitive treatment of diaphoresis, if the condition is not treatable by drug therapy. [1]
Initial manifestations often include an abnormal segmental sweating response (described as hyperhidrosis or anhidrosis in some patients) and a tonic pupil. Other commonly reported symptoms included fatigue, chronic cough, and increased urinary frequency. [6]
Adie tonic pupil: Tonic pupil is usually an isolated benign entity, presenting in young women. It may be associated with loss of deep tendon reflex (Adie's syndrome). Tonic pupil is characterized by delayed dilation of the iris, especially after near stimulus, segmental iris constriction, and sensitivity of pupil to a weak solution of pilocarpine.
The Marcus Gunn pupil is a relative afferent pupillary defect indicating a decreased pupillary response to light in the affected eye. [3] In the swinging flashlight test, a light is alternately shone into the left and right eyes. A normal response would be equal constriction of both pupils, regardless of which eye the light is directed at.
The older literature on AR pupils did not report the details of pupillary constriction (brisk vs. tonic) that are necessary to distinguish AR pupils from tonic pupils. Tonic pupils can occur in neurosyphilis. [3] It is not known whether neurosyphilis itself (infection by Treponema pallidum) can cause tonic pupils, or whether tonic pupils in ...
Parinaud's syndrome is a cluster of abnormalities of eye movement and pupil dysfunction, characterized by: Paralysis of upwards gaze: Downward gaze is usually preserved. This vertical palsy is supranuclear , so doll's head maneuver should elevate the eyes, but eventually all upward gaze mechanisms fail.
Paroxysmal tonic upgaze (PTU) of childhood is a rare and distinctive neuro-ophthalmological syndrome characterized by episodes of sustained upward deviation of the eyes. Symptoms normally appear in babies under one year of age and are characterized by an upward stare or gaze, with the eyes rolled back, while the chin is typically held low.
This dilation may pose a problem since a larger pupil is less efficient at focusing light (see pupil, aperture, and optical aberration for more.) Patients who have accommodative spasm may benefit from being given glasses or contacts that account for the problem or by using vision therapy techniques to regain control of the accommodative system.