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Tonic Pupil

Pupils Tonic


Presentation

  • Our case, only the second ever reported, emphasizes the importance of considering the diagnosis of neurosyphilis in patients presenting with an isolated acute tonic pupil.[ncbi.nlm.nih.gov]
Italian
  • […] pupils, Pupils, Adie's, Pupillatonia, Adie Pupil, Pupil, Adie, Adie pupil, Adie's pupil, Tonic pupillary reaction, Tonic pupil, Myotonic pupil, Holmes-Adie pupil, Tonic pupillary reaction (disorder), pupillotonia, Adie's pupil -RETIRED-, Tonic Pupil Italian[fpnotebook.com]
Anisocoria
  • The clearest difference found was in the degree of anisocoria, particularly in the light: patients with Adie/Ross syndrome are much more likely to have significant anisocoria compared with patients with a generalised neuropathy.[ncbi.nlm.nih.gov]
Blurred Vision
  • A 45-year-old woman developed progressive photophobia and blurred vision due to unilateral Adie's tonic pupil. Magnetic resonance image of her brain and neurological examination (including deep tendon reflexes) were normal at first visit.[ncbi.nlm.nih.gov]
  • The possibility of angle-closure glaucoma should be considered in patients with a tonic pupil, especially with symptoms of blurred vision or ocular pain. 2002 S. Karger AG, Basel References Harriman DG, Garland H: The pathology of Adie’s syndrome.[karger.com]
Pupillary Abnormality
  • This pupillary abnormality may result from ischaemia of the ciliary ganglia.[ncbi.nlm.nih.gov]
  • abnormality characterized by a poor pupillary light reaction, reduced accommodation, iris sector palsies, an enhanced pupillary response to near effort that results in a prolonged, "tonic" constriction, and slow pupillary redilation.[icd9data.com]
  • A pupillary abnormality characterized by a poor pupillary light reaction, reduced accommodation, iris sector palsies, an enhanced pupillary response to near effort that results in a prolonged, "tonic" constriction, and slow pupillary redilation.[lookfordiagnosis.com]
  • […] encyclopedia of medical concepts ψ ψ ψ Tonic Pupil More information in Books or on Definition : A pupillary abnormality characterized by a poor pupillary light reaction, reduced accommodation, iris sector palsies, an enhanced pupillary response to near[reference.md]
Headache
  • She complained of blurred vision and headache mainly while reading. She had a 35-year history of hepatitis B and liver cirrhosis.[ncbi.nlm.nih.gov]
  • The authors present a case of a 10-year-old girl who was referred with abnormal pupils and complained of headaches.[healio.com]
  • Indicates damage of ciliary ganglion. (1 pupil non-reactive to light) Differentials Posterior Synechiae Acute Angle Closure Tadpole Pupils (irregular shape pupils associated with headaches) Bitemporal Sphincter Palsy (vertically oriented pupils from OIS[odpalace.com]

Workup

  • Ocular Mass/Retrobulbar Mass PRP Systemic Diabetes Mellitus Syphillis Sarcoid Lyme Disease Characteristics Onset 20-40 years old, predominantly female (If Idiopathic) Associated Symptoms Diminished corneal sensitivity Decreased deep tendon reflexes Workup[odpalace.com]
  • Anisocoria workup repeated 2 weeks after the initial diagnosis of an acute right Adie's tonic pupil. a Pupils in the light. b Pupils on convergence. c Reversal of anisocoria 30 min after instillation of one drop of dilute pilocarpine (0.125%) in each[ncbi.nlm.nih.gov]
  • […] asymmetric, and these pupils are typically very difficult to dilate, which can help confirm the diagnosis. 15 Because of the association with chronic syphilis, systemic laboratory testing, including FTA-Abs and VDRL, should be included in these patients’ workup[reviewofoptometry.com]
  • […] headache Base of skull/carotid canal – tumor (nasopharyngeal CA) – trauma Middle ear – tumor (cholesteatoma) – infection Cavernous sinus – tumor (pituitary adenoma) – inflammation (Tolosa Hunt) – cavernous carotid aneurysm – thrombosis – fistula – further workup[lifeinthefastlane.com]
Human Herpesvirus 6
  • Human herpesvirus 6 (HHV-6), a widespread virus and causative agent of exanthema subitum in children, has been associated with a number of neurologic disorders including cranial nerve palsies, seizures, encephalitis, meningitis, and multiple sclerosis[ncbi.nlm.nih.gov]

Treatment

  • What is Traumatic Iritis: Causes, Symptoms, Treatment, Pathophysiology, Prognosis, Complications[epainassist.com]
  • Despite surgical and medical treatment for cancer, no change in the ocular condition was happened.[ncbi.nlm.nih.gov]
  • With appropriate treatment, the prognosis of Adie Syndrome is good Please find comprehensive information on Adie Syndrome regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention, prognosis[dovemed.com]

Prognosis

  • With appropriate treatment, the prognosis of Adie Syndrome is good Please find comprehensive information on Adie Syndrome regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention, prognosis[dovemed.com]
  • What is Traumatic Iritis: Causes, Symptoms, Treatment, Pathophysiology, Prognosis, Complications[epainassist.com]
  • What is the prognosis? Holmes-Adie syndrome is not life-threatening or disabling. The loss of deep tendon reflexes is permanent. Some symptoms of the disorder may progress. For most individuals, pilocarpine drops and glasses will improve vision.[web.archive.org]
  • Ten percent of cases are bilateral and the prognosis is benign. 1 Dorsal midbrain syndrome is characterized by several signs, including eyelid retraction, nystagmus, mid-dilated pupils with light-near dissociation, and paralysis of the upward gaze.[ncbi.nlm.nih.gov]
  • Prognosis Adie's tonic pupil is not a life threatening disease, but can cause photophobia and blurry vision due to poor iris function.[eyewiki.org]

Etiology

  • Adie's tonic pupil is benign neuro-ophthalmological disorder of unknown etiology. Most patients commonly present no symptoms and anisocoria is noticed accidentally. Although the etiology is unknown, there are some conditions that cause tonic pupil.[ncbi.nlm.nih.gov]
  • At this time, the underlying etiology of this disease is unknown.[eyewiki.org]
  • Adie's syndrome, or Holmes-Adie syndrome, refers to cases in which the etiology of the tonic pupils is unknown.[journalofoptometry.org]

Epidemiology

  • Th e epidemiology of Sjogren’s syndrome. Clin Epidemiol 2014;6:247-55. Gabriel SE, Michaud K. Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthritis Res Th er 2009;11:229.[scopublicaciones.socoftal.com]
  • Epidemiology Adie’s tonic pupil occurs in a 3:1 female to male ratio with an average age of onset of 32 years. [1] General Pathology It is thought that either a bacterial or viral infection causes inflammation which damages neurons in the ciliary ganglion[eyewiki.org]
  • Epidemiology Adie’s tonic pupil occurs in a 3:1 female to male ratio with an average age of onset of 32 years.[1] General Pathology It is thought that either a bacterial or viral infection causes inflammation which damages neurons in the ciliary ganglion[neuro-ophthalmology.stanford.edu]
Sex distribution
Age distribution

Pathophysiology

  • Abstract The accepted hypothesis for the pathophysiology of tonic pupil syndrome (Adie syndrome) was reexamined in light of recent developments concerning denervation supersensitivity of cholinergically innervated smooth muscle.[ncbi.nlm.nih.gov]
  • What is Traumatic Iritis: Causes, Symptoms, Treatment, Pathophysiology, Prognosis, Complications[epainassist.com]
  • Bilateral tonic pupil and polyneuropathy in Sjögren's syndrome: a common pathophysiological mechanism? Eur Neurol, 1991; 31: 114–116.[link.springer.com]
  • Pathophysiology Histologic examination of patients with Adie’s Syndrome has shown a reduction of ciliary ganglion cells. [1] The affected short ciliary neurons are postganglionic parasympathetic neurons which synapse within the ciliary ganglion and innervate[eyewiki.org]

Prevention

  • Currently, the exact cause of Adie syndrome has not been identified and it cannot be prevented Adie Syndrome presents with dilated pupil that react slowly to light, increased sensitivity to light, difficulty reading, and increased sweating.[dovemed.com]
  • Much of this research focuses on finding better ways to prevent, treat, and ultimately cure disorders, such as HAS. Select this link to view a list of studies currently seeking patients.[web.archive.org]
  • We can hope that Holmes-Adie Syndrome can be prevented and treated better in the days ahead.[weheartvision.com]
  • Prevention No preventative measures were noted. Resources BOOKS Bates, Barbara. A Pocket Guide to Physical Examination and History Taking. Philadelphia: Lippincott, 1991. Mareib, Elaine N. Essentials of Human Anatomy and Physiology, 3rd ed.[encyclopedia.com]

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