Adie syndrome / Holmes-Adie syndr / Adies

Tonic Pupil
Neuro disorder = Tonically dilated pupil that reacts slowly
to light but shows a more definite response to
accommodation (regeneration)
Typical patients = Female , 30s to 40s, presents with
blurred vision, photophobia and anisocoria
TRIAD = mydriasis + loss of deep tendon reflexes +
abnormal sweating
Dx = Clinical + PILOCARPINE (constricts due to
cholinergic denervation)
Tx = prescribe glasses +/- PILOCARPINE
PILOCARPINE Non-selevtive muscarinic receptor agonist
in parasym system , used to treat xerostomia (Sjogren),
glaucoma (ciliary muscle contracts = opens trabecular
meshwork through increased tension on the scleral spur) ;
SWEAT TEST for CF ; S/E = sweating, salivation, brow ache
Pathophysiology :
1. Viral or bacterial infection causes inflammation
2. To neurons in the CILIARY GANGLION what provides
parasym to eye
3. Autonomic problem=damage to DORSAL ROOT
GANGLIA (spinal cord)