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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 the iris, especially after near stimulus, segmental iris constriction, and sensitivity of pupil to a weak solution of pilocarpine.
Ross' syndrome consists of Adie's syndrome (myotonic pupils and absent deep tendon reflexes) plus segmental anhidrosis (typically associated with compensatory hyperhidrosis). [1] It was characterized in 1958 [2] [3] by A.T. Ross. [4] By 1992, eighteen cases had been documented. [5]
Adie syndrome [4] is tonic pupil plus absent deep tendon reflexes. Adie syndrome is a fairly common, benign, idiopathic neuropathy that selectively affects the ciliary ganglion and the spinal cord neurons involved in deep tendon reflex arcs.
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.
Marcus Gunn pupil: The left optic nerve and the optic tracts. A Marcus Gunn pupil indicates an afferent defect, usually at the level of the retina or optic nerve. Moving a bright light from the unaffected eye to the affected eye would cause both eyes to dilate, because the ability to perceive the bright light is diminished. Specialty
Adie's pupil, which fails to constrict in response to light; aniridia, which is absence of the iris; and albinism, where the iris is defectively pigmented, may also cause this. Central cataracts , due to the lens clouding, disperses the light before it can reach the retina and is a common cause of hemeralopia and photoaversion in the elderly.
A link between scleral buckles and Adie syndrome may exist. [ 2 ] Results from three randomized controlled trials of 274 patients comparing retinal detachment outcomes from pneumatic retinopexy versus scleral buckle found some evidence suggesting that scleral buckle was less likely to result in a recurrence of retinal detachment than pneumatic ...