Adie syndrome, sometimes known as Holmes-Adie’s syndrome or Adie’s Tonic Pupil, is a neurological disorder which affects the pupil of the eye and the autonomic nervous system.[1] It is named for William John Adie. It is caused by damage to the postganglionic fibers of the parasympathetic innervation of the eye, usually by a viral or bacterial infection which causes inflammation, and characterized by a tonically dilated pupil.[1]<\/p>\n\n\n\n
This photograph shows an abnormally sized pupil which has been dilated with eye drops<\/p>\n\n\n\n
Adie syndrome presents with three hallmark symptoms, namely abnormal pupil size (mydriasis), loss of deep tendon reflexes and diaphoresis.[1] Other signs may include hyperopia due to accommodative paresis, photophobia and difficulty reading.[2]<\/p>\n\n\n\n
Clinical exam may reveal sectoral paresis of the iris sphincter and\/or vermiform iris movements. The tonic pupil may become smaller (miotic) over time which is referred to as “little old Adie’s”.[3] Testing with low dose (1\/8%) pilocarpine may constrict the tonic pupil due to cholinergic denervation supersensitivity.[1] A normal pupil will not constrict with the dilute dose of pilocarpine.[3] CT scans and MRI scans may be useful in the diagnostic testing of focal hypoactive reflexes.[4]<\/p>\n\n\n\n
The usual treatment of a standardised Adie syndrome is to prescribe reading glasses to correct for impairment of the eye(s).[1] Pilocarpine drops may be administered as a treatment as well as a diagnostic measure, and should be applied three times daily.[1] Thoracic sympathectomy is the definitive treatment of diaphoresis, if the condition is not treatable by drug therapy.[1]<\/p>\n\n\n\n
Adie’s syndrome is not life threatening or disabling.[1] As such, there is no mortality rate relating to the condition, however loss of deep tendon reflexes is permanent and may progress over time.[1]<\/p>\n","protected":false},"excerpt":{"rendered":"
Adie syndrome, sometimes known as Holmes-Adie’s syndrome or Adie’s Tonic Pupil, is a neurological disorder which affects the pupil of the eye and the autonomic nervous system.[1] It is named for William John Adie. It is caused by damage to the postganglionic fibers of the parasympathetic innervation of the eye, … <\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.eyecare-information-service.org.uk\/wp-json\/wp\/v2\/pages\/15"}],"collection":[{"href":"https:\/\/www.eyecare-information-service.org.uk\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.eyecare-information-service.org.uk\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.eyecare-information-service.org.uk\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.eyecare-information-service.org.uk\/wp-json\/wp\/v2\/comments?post=15"}],"version-history":[{"count":0,"href":"https:\/\/www.eyecare-information-service.org.uk\/wp-json\/wp\/v2\/pages\/15\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.eyecare-information-service.org.uk\/wp-json\/wp\/v2\/media?parent=15"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}