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Adie syndrome, also known as Holmes–Adie syndrome, 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). [1] It is frequently seen in females with absent knee or ankle jerks and impaired sweating.
Adie's pupil is caused by damage to peripheral pathways to the pupil (parasympathetic neurons in the ciliary ganglion that cause pupillary constriction to bright light and with near vision). The pathophysiologic mechanism which produces an Argyll Robertson pupil is unclear, but is believed to be the result of bilateral damage to the pretectal ...
Adie pupil: William John Adie: neurology: ciliary nerve damage: dilated pupil, poorly reactive but with normal near accommodation Adson's sign: Alfred Washington Adson: vascular surgery: thoracic outlet syndrome: obliteration of radial pulse with manoeuvres Alexander's law: Gustav Alexander: neurology, neurosurgery, ENT: vestibular lesions
Marcus Gunn pupil: The left optic nerve and the optic tracts. A Marcus Gunn pupil indicates an afferent defect, usually at the level of the retina or optic nerve. Moving a bright light from the unaffected eye to the affected eye would cause both eyes to dilate, because the ability to perceive the bright light is diminished. Specialty
Dilation and constriction of the pupil Pupillary response is a physiological response that varies the size of the pupil between 1.5 mm and 8 mm, [ 1 ] via the optic and oculomotor cranial nerve. A constriction response ( miosis ), [ 2 ] is the narrowing of the pupil, which may be caused by scleral buckles or drugs such as opiates / opioids or ...
Adie syndrome [4] is tonic pupil plus absent deep tendon reflexes. Adie syndrome is a fairly common, benign, idiopathic neuropathy that selectively affects the ciliary ganglion and the spinal cord neurons involved in deep tendon reflex arcs.
Adie's pupil, which fails to constrict in response to light; aniridia, which is absence of the iris; and albinism, where the iris is defectively pigmented, may also cause this. Central cataracts , due to the lens clouding, disperses the light before it can reach the retina and is a common cause of hemeralopia and photoaversion in the elderly.
Nerves involved in the resizing of the pupil connect to the pretectal nucleus of the high midbrain, bypassing the lateral geniculate nucleus and the primary visual cortex. From the pretectal nucleus neurons send axons to neurons of the Edinger-Westphal nucleus whose visceromotor axons run along both the left and right oculomotor nerves .