Unilateral involvement is observed in 80% of patients. Patients usually observe that 1 pupil is larger than the other when looking in the mirror. Adie’s pupil is predominantly seen in young women, with an age of onset of 20 to 40 years. It manifests as unilateral or bilateral pupil dilation, direct and indirect loss or weakening of light reflection, abnormal adjustment reflex, and pupil contraction disorder. Īdie’s pupil, also called tonic pupil, was first reported by the British neurologist William John Adie in 1931.
The first is the light reflex, which causes bilateral pupils to shrink when 1 pupil is illuminated the second is the accommodative reflex, also known as the near reflex, which is manifested by the bilateral pupil constriction when staring at a nearby object. However, the contraction of the pupillary dilator muscle when innervated by the sympathetic nerve fibers dilates the pupil. The contraction of the pupillary sphincter muscle when innervated by the parasympathetic nerve fibers shrinks the pupil. The size of the pupil is adjusted by the pupillary sphincter and dilator. Here, the clinical manifestations, pathogenesis, relationship between Adie’s pupil and diseases, and differential diagnosis of Adie’s pupil are reviewed. 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. It is essential for clinicians to improve their understanding of the disease to avoid misdiagnosis. Pilocarpine can be used to treat ophthalmologic symptoms, such as blurred vision, for which patients might visit an ophthalmologist or neurologist. The ophthalmological symptoms and pupil abnormalities can disappear after active treatment of the primary disease. 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 pathogeneses of Adie’s pupil are complex, some of which are insidious and lack corresponding specific diseases. The pupil on the affected side is sensitive to low concentrations of pilocarpine. The direct and indirect light reflection from the pupil on the affected side disappears. The pupil of the affected side is significantly larger than that on the healthy side. Most patients have unilateral eye involvement.
Adie’s pupil, also called tonic pupil, is mainly seen in young women.
0 kommentar(er)
