The pharmacological treatment for Adie's tonic pupil is typically supportive in nature. Pilocarpine is the most commonly used medication to treat Adie's tonic pupil. Pilocarpine is an miotic, or a drug that causes the pupil to constrict. It is typically used in a low dose and may need to be applied several times a day. A topical anesthetic, such as tetracaine, may be applied to reduce discomfort associated with the pilocarpine application. Other medications, such as atropine or phenylephrine, may also be used to treat Adie's tonic pupil, but these are not as effective as pilocarpine.
In some cases, botulinum toxin injections may be used to treat Adie's tonic pupil. Botulinum toxin injections can help to reduce the size of the pupil, and can also reduce the degree of light sensitivity. Botulinum toxin injections are more effective when used in combination with pilocarpine, as this allows for more precise control of the pupil size.
In addition to pharmacological treatments, physical therapy and lifestyle modifications can also be used to manage Adie's tonic pupil. Physical therapy, such as general eye exercises and stretching, can help to reduce the size of the pupil and improve vision. Lifestyle changes, such as wearing sunglasses, avoiding bright lights, and using artificial tears, can also help to reduce the symptoms associated with Adie's tonic pupil.