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Adie's tonic pupil is usually associated with a benign peripheral neuropathy (Adie syndrome), not with syphilis. [ 6 ] When penicillin became widely available in the 1940s, the prevalence of AR pupils (which develop only after decades of untreated infection) decreased dramatically.
Adie syndrome, also known as Holmes–Adie syndrome, is a neurological disorder characterized by a tonically dilated pupil that reacts slowly to light but shows a more definite response to accommodation (i.e., light-near dissociation). [1] It is frequently seen in females with absent knee or ankle jerks and impaired sweating.
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 iris especially after near stimulus, segmental iris constriction, and sensitivity of pupil to a weak solution of pilocarpine.
A relative afferent pupillary defect (RAPD), also known as a Marcus Gunn pupil (after Robert Marcus Gunn), is a medical sign observed during the swinging-flashlight test [1] whereupon the patient's pupils excessively dilate when a bright light is swung from the unaffected eye to the affected eye. The affected eye still senses the light and ...
Other causes of light-near dissociation involve damage to the brainstem, [citation needed] where a tonic pupil is not produced. Brainstem causes of light-near dissociation include Argyll Robertson pupil and Parinaud syndrome. Irene Loewenfeld is generally credited for being the first physiologist to make this distinction.
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. In the extreme form, conjugate down gaze ...
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accommodative iridoplegia- Noncontraction of pupils during accommodation. complete iridoplegia- Iris fails to respond to any stimulation. reflex iridoplegia- The absence of light reflex, with retention of accommodation reflex. Also called Argyll Robertson pupil.