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Adie’s Tonic Pupil



    • 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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