Adie's pupil

Adie's syndrome
Bilateral mydriasis given the observational diagnosis Adie's pupils by an ophthalmologist
Classification and external resources
Specialty	ophthalmology
ICD-10	H57.0
ICD-9-CM	379.46
DiseasesDB	29742
MeSH	D015845
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Adie syndrome (/ˈeɪdi/), sometimes known as Holmes–Adie syndrome or Adie's tonic pupil, is a neurological disorder characterized by a tonically dilated pupil that reacts slowly to light but shows a more definite response to accommodation (i.e., light-near dissociation). It is frequently seen in females with absent knee or ankle jerks and impaired sweating. It is named after the British neurologist William John Adie. It is caused by damage to the postganglionic fibers of the parasympathethethetic innervation of the eye, usually by a viral or bacterial infection which causes inflammation, and affects the pupil of the eye and the autonomic nervous system.

Adie syndrome presents with three hallmark symptoms, namely at least one abnormally dilated pupil (mydriasis) which does not constrict in response to light, loss of deep tendon reflexes, and abnormalities of sweating. Other signs may include hyperopia due to accommodative paresis, photophobia and difficulty reading.

Pupillary symptoms of Holmes–Adie syndrome are thought to be the result of a viral or bacterial infection that causes inflammation and damage to neurons in the ciliary ganglion, located in the posterior orbit, that provides parasympathetic control of eye constriction. Additionally, patients with Holmes-Adie Syndrome can also experience problems with autonomic control of the body. This second set of symptoms is caused by damage to the dorsal root ganglia of the spinal cord.

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