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Adie syndrome presents with three hallmark symptoms, namely at least one abnormally dilated pupil which does not constrict in response to light, loss of deep tendon reflexes, and abnormalities of sweating. [1] Other signs may include hyperopia due to accommodative paresis, photophobia and difficulty reading. [3]
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 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.
Adie's pupil is caused by damage to peripheral pathways to the pupil (parasympathetic neurons in the ciliary ganglion that cause pupillary constriction to bright light and with near vision). The pathophysiologic mechanism which produces an Argyll Robertson pupil is unclear, but is believed to be the result of bilateral damage to the pretectal ...
Adie pupil: William John Adie: neurology: ciliary nerve damage: dilated pupil, poorly reactive but with normal near accommodation Adson's sign: Alfred Washington Adson: vascular surgery: thoracic outlet syndrome: obliteration of radial pulse with manoeuvres Alexander's law: Gustav Alexander: neurology, neurosurgery, ENT: vestibular lesions
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.
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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.