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adie_tonic_pupil [2026/06/22 00:34] – Scott Larsonadie_tonic_pupil [2026/06/22 00:39] (current) – [Characteristics] Scott Larson
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   * Unilateral in 80%   * Unilateral in 80%
   * Light-near dissociation   * Light-near dissociation
-    * dysinnervation of the iris sphincter parasympathetic input but recovery of the accommodative iris sphincter input +    * dysinnervation of the iris sphincter parasympathetic innervation is present but recovery of the accommodative iris sphincter input occurs
     * slow tonic constriction to near fixation (light/near dissociation) and slow redilation     * slow tonic constriction to near fixation (light/near dissociation) and slow redilation
   * Segmental iris sphincter paresis produces vermiform movements    * Segmental iris sphincter paresis produces vermiform movements 
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     * Because this response is due to supersensitvity, it may not be present within 2 months of onset      * Because this response is due to supersensitvity, it may not be present within 2 months of onset 
     * False positive results in pre ganglionic CN III lesions.      * False positive results in pre ganglionic CN III lesions. 
 +  * Dilute Pilocarpine 1% in solution with sterile saline 
 +    * 1 part pilocarpine 1% and 9 parts saline gives 0.1%) 
  
 ====Prognosis==== ====Prognosis====
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   - [[https://pmc.ncbi.nlm.nih.gov/articles/PMC8115311/|Dilute pilocarpine test for diagnosis of Adie's tonic pupil. Yung-Ju Yoo et al.  Sci Rep. 2021. 11L:10089]]   - [[https://pmc.ncbi.nlm.nih.gov/articles/PMC8115311/|Dilute pilocarpine test for diagnosis of Adie's tonic pupil. Yung-Ju Yoo et al.  Sci Rep. 2021. 11L:10089]]
   - [[https://eyewiki.org/Adie_Pupil|Eyewiki: Adie Pupil]]   - [[https://eyewiki.org/Adie_Pupil|Eyewiki: Adie Pupil]]
-  - [[https://pubmed.ncbi.nlm.nih.gov/11860969/Leavitt JA, Wayman LL, Hodge DO, Brubaker RF. Pupillary response to four concentrations of pilocarpine in normal subjects: application to testing for Adie tonic pupil. Am J Ophthalmol. 2002;133:333-336]]+  - [[https://pubmed.ncbi.nlm.nih.gov/11860969/|Leavitt JA, Wayman LL, Hodge DO, Brubaker RF. Pupillary response to four concentrations of pilocarpine in normal subjects: application to testing for Adie tonic pupil. Am J Ophthalmol. 2002;133:333-336]]