Adie's pupil, also called tonic pupil, is a condition characterized by an abnormally slow or sluggish pupillary response to light and near stimulus, and a reduced or absent reaction to accommodation. It is usually caused by damage to the postganglionic parasympathetic nerve fibers that innervate the pupillary constrictor muscles.
Pathophysiology
Adie's pupil is caused by damage to the postganglionic parasympathetic nerve fibers that innervate the pupillary constrictor muscles, resulting in an abnormally slow or sluggish pupillary response to light and near stimulus, and a reduced or absent reaction to accommodation. The underlying cause of Adie's pupil is unknown, but it can be associated with viral infections, autoimmune diseases, head injuries, brain tumors, and certain medications.
Diagnosis
Adie's pupil is typically diagnosed by physical exam. The doctor will examine the pupil size and response to light and near stimuli. If the pupil is abnormally sluggish or does not constrict when focusing on near objects, Adie's pupil may be diagnosed.
Treatment
Adie's pupil is usually a benign condition that does not require treatment. If the pupil constricts slowly but the patient is asymptomatic, no treatment is needed. If the patient has persistent symptoms, such as blurred vision, eye strain, or difficulty focusing, the doctor may prescribe eyedrops to help constrict the pupil.