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Medical Science Monitor : International... Mar 2022Adie's pupil, also called tonic pupil, is mainly seen in young women. Most patients have unilateral eye involvement. The pupil of the affected side is significantly... (Review)
Review
Adie's pupil, also called tonic pupil, is mainly seen in young women. Most patients have unilateral eye involvement. The pupil of the affected side is significantly larger than that on the healthy side. The direct and indirect light reflection from the pupil on the affected side disappears. The pupil on the affected side is sensitive to low concentrations of pilocarpine. The pathogeneses of Adie's pupil are complex, some of which are insidious and lack corresponding specific diseases. Through a literature review, we found that Adie's pupil is mainly associated with infectious diseases, most commonly syphilis, followed by immune diseases and paraneoplastic syndromes. The ophthalmological symptoms and pupil abnormalities can disappear after active treatment of the primary disease. Pilocarpine can be used to treat ophthalmologic symptoms, such as blurred vision, for which patients might visit an ophthalmologist or neurologist. It is essential for clinicians to improve their understanding of the disease to avoid misdiagnosis. Differential diagnosis between Adie's pupil, oculomotor nerve palsy, anticholinergic drug overdose, Argyll-Robertson pupil, and congenital mydriasis need to be identified by the physician. Here, the clinical manifestations, pathogenesis, relationship between Adie's pupil and diseases, and differential diagnosis of Adie's pupil are reviewed.
Topics: Adie Syndrome; Diagnosis, Differential; Humans; Physicians; Pupil; Tonic Pupil
PubMed: 35304432
DOI: 10.12659/MSM.934657 -
United States Armed Forces Medical... Oct 1951
Topics: Adie Syndrome; Humans
PubMed: 14876814
DOI: No ID Found -
Journal of Ophthalmic Nursing &... 1985
Topics: Adie Syndrome; Humans; Pupil
PubMed: 3844040
DOI: No ID Found -
Archives of Neurology Jun 1968
Topics: Adie Syndrome; England; History, 20th Century
PubMed: 4871169
DOI: 10.1001/archneur.1968.00470360132015 -
Medical Journal, Armed Forces India Dec 2023A 30-year-old male patient presented to the eye department with complaints of blurring of vision of right eye at distance and near for a duration of 1.5 months. Ocular...
A 30-year-old male patient presented to the eye department with complaints of blurring of vision of right eye at distance and near for a duration of 1.5 months. Ocular examination revealed Anisocoria with enlarged pupil in the right eye. On instillation of 0.1% pilocarpine, there was a pronounced miosis in the dilated pupil seen at 30 min associated with an improvement in distance and near vision. On slit lamp examination, vermiform movements were seen in the affected pupil on shining the slit from temporal aspect. Fundus examination was within normal limits. Systemic examination revealed absent deep tendon reflexes. Based on the clinical features, a diagnosis of Holmes-Adie syndrome was reached and the patient was started on 0.1% pilocarpine eye drops. This case highlights the importance of thorough systemic examination and investigations in all cases of anisocoria.
PubMed: 38144644
DOI: 10.1016/j.mjafi.2022.01.008 -
Lancet (London, England) Mar 2001
Topics: Adie Syndrome; Adult; Female; Humans; Lyme Disease
PubMed: 11254002
DOI: 10.1016/S0140-6736(05)71234-4 -
Medicina Clinica May 2012
Topics: Adie Syndrome; Adolescent; Female; Humans; Mydriasis
PubMed: 22036461
DOI: 10.1016/j.medcli.2011.09.010 -
Acta Paediatrica Japonica : Overseas... Jun 1997An 8-year-old girl with a history of mild amblyopia who had occlusion therapy, but her anisocoria went unnoticed, was studied. Old photographs of the patient were...
An 8-year-old girl with a history of mild amblyopia who had occlusion therapy, but her anisocoria went unnoticed, was studied. Old photographs of the patient were reviewed and a 0.1% pilocarpine test was performed. Review of her old photographs suggested that she had anisocoria at least since she was 3 years old. The 0.1% pilocarpine test confirmed a diagnosis of Adie's syndrome. In light of this case, it must be kept in mind that though rare, Adie's syndrome can be encountered in early childhood.
Topics: Adie Syndrome; Age of Onset; Child; Female; Humans
PubMed: 9241912
DOI: 10.1111/j.1442-200x.1997.tb03764.x -
Current Opinion in Neurology Feb 2008To give an overview on topics of pupillary function selected according to their relevance in clinical neurology. Mainly publications of the last 3 years have been...
PURPOSE OF REVIEW
To give an overview on topics of pupillary function selected according to their relevance in clinical neurology. Mainly publications of the last 3 years have been considered.
RECENT FINDINGS
The discovery of photosensitive retinal ganglion cells not serving vision, but serving circadian rhythm and the pupil initiated many studies. There is evidence that pupil reaction to light might be preserved even if all rods and cones are lost. Spontaneous pupillary contractions in darkness occur in sleepy subjects and have been used to quantify the state of alertness. Apraclonidine eye drops have been suggested to diagnose Horner syndrome. Iatrogenic cause and carotid artery dissection are the most frequently reported underlying causes of Horner syndrome. Anti-Hu antibodies may be associated with tonic pupils.
SUMMARY
Pupil studies in blind patients may give new insights into the function of the pupillary system. Testing for sleepiness by means of pupillography might be used more frequently. Testing for Horner syndrome still needs to be done with cocaine eye drops. Clinical evaluation has to be focused on detecting additional signs and symptoms. Unknown malignancy is very rare. In the tonic pupil (Adie syndrome) autoantibodies may play a role, in exceptional cases it might represent a paraneoplastic disorder.
Topics: Adaptation, Ocular; Adrenergic alpha-Agonists; Animals; Clonidine; Humans; Pupil; Pupil Disorders; Reflex, Pupillary; Retina
PubMed: 18180650
DOI: 10.1097/WCO.0b013e3282f39173