No abstract available.
Neurosyphilis ; Pilocarpine ; Tonic Pupil

Orbital trauma and surgery are recognised aetiological factors of tonic pupil. Tonic or Adie's pupil is an efferent pupil defect in which light reactions to one or more segments of the iris sphincter are lost due to the postganglionic parasympathetic nerves damage from ciliary ganglion. There is loss of part or all of the light reflex and decrease in accommodative functions at near. We report a case of tonic pupil in a 42-year-lady after a successful surgical removal of an orbital cavernous haemangioma.
Tonic Pupil ; Haemangioma, Carvenous ; Adie Syndrome

Adie's tonic pupil usually consists of mydriasis, defect in accommodation. Poor or absent light reflex, and tonic near reflex, It is usually unilateral, but rarelY observed bilaterally. The pupillary abnormalities often accompany areflexia, which is called Adie syndrome collechvely, Other autonomic dysfunction especially hypohidrosis. Are rarely reported in association with Adie syndrome. We recently experienced 2 cases of bilateral Adie's pupils in 2 women, one of whom had hypohidrosis, and the other had areflexia. So we report 2 cases with bilateral Adie's pupils with a review of literature.
Adie Syndrome ; Female ; Humans ; Hypohidrosis ; Mydriasis ; Reflex ; Tonic Pupil*

A case of tonic pupil in a 32 years-old Korean male has been reported. This is a rare disease and hitherto it is not reported in Korea. A brief review of literatures has also been described.
Adult ; Humans ; Korea ; Male ; Rare Diseases ; Tonic Pupil*

PURPOSE: Denervation supersensitivity to 0.125% pilocarpine is an important factor in making a diagnosis of Adie's tonic pupil. However, it generally takes several weeks for denervation supersensitivity to manifest after an injury to the nerve ganglion. We report a case of 'acute' Adie's tonic pupil before the manifestation of denervation supersensitivity. CASE SUMMARY: A 53-year-old man with no significant past medical history visited our clinic, reporting mydriasis of his left eye. Pupil size was 8 mm in the right eye, 3 mm in the left. Loss of both direct/indirect light reflex and light-near reflex were observed. The left pupil did not react to 0.125% Pilocarpine, but constricted in response to 1% pilocarpine. After 5 months, the pupil size did not change, but the pupil constricted in response to 0.125% pilocarpine. CONCLUSIONS: In an isolated case of dilated pupil, though the pupil did not react to 0.125% pilocarpine, with respect to the Adie's tonic pupil, to check the manifestation of denervation supersensitivity should be needed at regular intervals.
Denervation ; Eye ; Ganglion Cysts ; Humans ; Hypersensitivity ; Light ; Middle Aged ; Mydriasis ; Pilocarpine ; Pupil ; Reflex ; Tonic Pupil

PURPOSE: Denervation supersensitivity to 0.125% pilocarpine is an important factor in making a diagnosis of Adie's tonic pupil. However, it generally takes several weeks for denervation supersensitivity to manifest after an injury to the nerve ganglion. We report a case of 'acute' Adie's tonic pupil before the manifestation of denervation supersensitivity. CASE SUMMARY: A 53-year-old man with no significant past medical history visited our clinic, reporting mydriasis of his left eye. Pupil size was 8 mm in the right eye, 3 mm in the left. Loss of both direct/indirect light reflex and light-near reflex were observed. The left pupil did not react to 0.125% Pilocarpine, but constricted in response to 1% pilocarpine. After 5 months, the pupil size did not change, but the pupil constricted in response to 0.125% pilocarpine. CONCLUSIONS: In an isolated case of dilated pupil, though the pupil did not react to 0.125% pilocarpine, with respect to the Adie's tonic pupil, to check the manifestation of denervation supersensitivity should be needed at regular intervals.
Denervation ; Eye ; Ganglion Cysts ; Humans ; Hypersensitivity ; Light ; Middle Aged ; Mydriasis ; Pilocarpine ; Pupil ; Reflex ; Tonic Pupil

A Dilated pupil with a loss of reactions to light and accommodation convergence exhibit these defects in varying degree, and occur under a variety of circumstances. These conditions include unilateral dilatation and fixity of the pupil as a result of injury to the eye and as the result of ipsilateral cerebral compression and bilaterally dilated and fixed pupils seen commonly in juvenile paresis and tabo-paresis. There are another unknown circumstances as tonic pupil. The authors presented a case of 22 years old Korean female under the diagnosis of dilated and fixed pupil which possibly originated from syphilis in as much as she was strongly positive reaction in serum S.T.S. and her abnormal pupil was recovered after anti-syphilitic therapy. The authors reviewed the literatures concerning these conditions and discussed about the possibility of early involvement of syphilis in the nervous system and the possible site of lesion which interefere pupillary reflex to light and accommodation-convergence. Finally authors commented the possible site of lesion is efferent pupilloconstrictor fibers which pass through the tentorial gap. In this region para-sympathetic pupilloconstrictor fibers, concentrated over the superior are of the oculomotor nerve, may be compressed upon its superior surface by inflammatory swelling of syphilitic involvement of adjacent structures.
Diagnosis ; Dilatation ; Female ; Humans ; Nervous System ; Neurosyphilis ; Oculomotor Nerve ; Pupil ; Pupil Disorders* ; Reflex, Pupillary ; Syphilis ; Tonic Pupil ; Young Adult

The pupillary size and movement are controlled dynamically by the autonomic nervous system; the parasympathetic system constricts the iris, while the sympathetic system dilates the iris. Under normal conditions, these constrictions and dilations occur identically in both eyes. Asymmetry in the pupillomotor neural input or output leads to impaired pupillary movement on one side and an unequal pupil size between both eyes. Anisocoria is one of the most common signs in neuro-ophthalmology, and the neurological disorders that frequently cause anisocoria include serious diseases, such as vascular dissection, fistula, and aneurysm. A careful history and examination can identify and localize pupillary disorders and provide a guide for appropriate evaluations.
Aneurysm ; Anisocoria ; Autonomic Nervous System ; Constriction ; Fistula ; Horner Syndrome ; Iris ; Nervous System Diseases ; Pupil ; Pupil Disorders ; Tonic Pupil

The pupillary size and movement are controlled dynamically by the autonomic nervous system; the parasympathetic system constricts the iris, while the sympathetic system dilates the iris. Under normal conditions, these constrictions and dilations occur identically in both eyes. Asymmetry in the pupillomotor neural input or output leads to impaired pupillary movement on one side and an unequal pupil size between both eyes. Anisocoria is one of the most common signs in neuro-ophthalmology, and the neurological disorders that frequently cause anisocoria include serious diseases, such as vascular dissection, fistula, and aneurysm. A careful history and examination can identify and localize pupillary disorders and provide a guide for appropriate evaluations.
Aneurysm ; Anisocoria ; Autonomic Nervous System ; Constriction ; Fistula ; Horner Syndrome ; Iris ; Nervous System Diseases ; Pupil ; Pupil Disorders ; Tonic Pupil

BACKGROUND: Adie's tonic pupil consists of mydriasis, accommodation defect, decreased light reflex, and tonic near reflex. When tonic pupil is combined with hypo- or areflexia, it is called Holmes-Adie syndrome. CASE: Fifty-two-year-old and 37-year-old female patients showed unilateral dilated irregular pupil, decreased light reflex, and decreased or absent DTR. When 0.125% pilocarpine was dropped on the dilated pupil, the pupil was constricted after pilocarpine application. Somatosensory evoked potentials were within normal ranges, and H-reflex responses were absent or delayed.
Adie Syndrome* ; Adult ; Evoked Potentials, Somatosensory ; Female ; H-Reflex ; Humans ; Mydriasis ; Pilocarpine ; Pupil ; Reference Values ; Reflex ; Tonic Pupil