Tonic pupil

Aka: Tonic pupil, Adie's Pupil

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II. Pathophysiology

  1. Normal variant
  2. May be seen in younger persons with widened pupils
  3. Parasympathetic fiber inhibition, while sympathetic chain is intact and functioning
  4. Images
    1. EyePupillaryReactionNeuroPath.png
    2. EyePupillaryReaction.png

III. Signs

  1. Sluggish pupil reaction to light with prolonged latency
    1. Pupil remains relatively dilated despite light exposure
  2. May be unilateral
  3. Pupil can accommodate

IV. Differential Diagnosis

  1. See Anisocoria
  2. Argyll Robertson Pupil
    1. Tonic pupil dilates with Atropine (contrast with Argyll Robertson Pupil)

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Related Topics in Pupil Disorders

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