Show Summary Details
Page of

Tonic Pupil 

Tonic Pupil
Chapter:
Tonic Pupil
Author(s):

Matthew J. Thurtell

, and Robert L. Tomsak

DOI:
10.1093/med/9780190603953.003.0036
Page of

PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). © Oxford University Press, 2021. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 24 February 2021

A tonic pupil is caused by a lesion affecting the postganglionic parasympathetic innervation of the pupil. It can be an incidental finding on examination or associated with visual symptoms, such as photophobia. In this chapter, we begin by briefly reviewing the differential diagnosis of photophobia. We next review the characteristic features of tonic pupil, which include poor pupil reaction to light, segmental palsy of the iris sphincter muscle, accommodation palsy, and tonic pupil reaction to near. We then review the causes of tonic pupil, which include viral infections, trauma, orbital surgery, or neurologic diseases, such as Miller Fisher syndrome. We then go on to discuss the clinical features, diagnostic evaluation, and prognosis of idiopathic tonic pupil, which is also known as an Adie pupil. Lastly, we briefly discuss the management options for tonic pupil, which include use of sunglasses and dilute pilocarpine eye drops.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.