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Adie's Tonic Pupil

March 3rd, 2023


  • Look For

  • Dilatation of one or both pupils
  • Unresponsiveness to light
  • Intact accomodation reflex (near light dissociation)
  • Significance

  • Indicates loss of postganglionic parasympathetic innervation of the sphincter pupillae and ciliary muscles.
This finding is commonly associated with knee / ankle areflexia (Holmes-Adie syndrome)
  • Causes of Adie's Tonic Pupil

  • Viral infection
  • Trauma
  • Orbital tumour
  • Vasospasm (migraine)
  • Idiopathic
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