Unilateral Adie's tonic pupil and viral hepatitis: Report of two cases
Introduction. Adie’s (tonic) pupil is a neuro-ophthalmological disorder characterized by a tonically dilated pupil, which is unresponsive to light. It is caused by damage to postganglionic fibers of the parasympathetic innervation of the eye, usually by a viral or bacterial infection. Adie’...
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doaj-1ec15127c5fe4d86a1cbb96553e760d62021-01-02T02:13:09ZengSerbian Medical SocietySrpski Arhiv za Celokupno Lekarstvo0370-81792406-08952015-01-011437-845145410.2298/SARH1508451K0370-81791508451KUnilateral Adie's tonic pupil and viral hepatitis: Report of two casesKaradžić Jelena0Jaković Natalija1Kovačević Igor2Clinical Center of Serbia, Clinic for Eye Diseases, BelgradeClinical Center of Serbia, Clinic for Eye Diseases, Belgrade + School of Medicine, BelgradeClinical Center of Serbia, Clinic for Eye Diseases, Belgrade + School of Medicine, BelgradeIntroduction. Adie’s (tonic) pupil is a neuro-ophthalmological disorder characterized by a tonically dilated pupil, which is unresponsive to light. It is caused by damage to postganglionic fibers of the parasympathetic innervation of the eye, usually by a viral or bacterial infection. Adie’s syndrome includes diminished deep tendon reflexes. Outline of Cases. We report data of a 59-year-old female with unequal pupil sizes. She complained of blurred vision and headache mainly while reading. She had a 35-year history of hepatitis B and liver cirrhosis. On exam, left pupil was mydriatic and there was no response to light and at slit lamp we saw segments of the sphincter constrict. We performed 0.125% pilocarpine test and there was a remarkable reduction of size in the left pupil. The second case is a 55-year-old female who was referred to the University Eye Clinic because of a headache and mydriatic left pupil. She had diabetes mellitus type 2, as well as hepatitis A virus 20 years earlier. On exam, the left pupil was mydriatic, with no response to light. Test with diluted pilocarpine was positive. Neurological examinations revealed no abnormality in either case so we excluded Adie’s syndrome. Conclusion. Adie’s tonic pupil is benign neuro-ophthalmological disorder of unknown etiology. Most patients commonly present no symptoms and anisocoria is noticed accidentally. Although the etiology is unknown, there are some conditions that cause tonic pupil. It may be a part of a syndrome in which tonic pupil is associated with absent deep tendon reflexes.http://www.doiserbia.nb.rs/img/doi/0370-8179/2015/0370-81791508451K.pdfAdie’s tonic pupilviral hepatitisAdie’s syndrome |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Karadžić Jelena Jaković Natalija Kovačević Igor |
spellingShingle |
Karadžić Jelena Jaković Natalija Kovačević Igor Unilateral Adie's tonic pupil and viral hepatitis: Report of two cases Srpski Arhiv za Celokupno Lekarstvo Adie’s tonic pupil viral hepatitis Adie’s syndrome |
author_facet |
Karadžić Jelena Jaković Natalija Kovačević Igor |
author_sort |
Karadžić Jelena |
title |
Unilateral Adie's tonic pupil and viral hepatitis: Report of two cases |
title_short |
Unilateral Adie's tonic pupil and viral hepatitis: Report of two cases |
title_full |
Unilateral Adie's tonic pupil and viral hepatitis: Report of two cases |
title_fullStr |
Unilateral Adie's tonic pupil and viral hepatitis: Report of two cases |
title_full_unstemmed |
Unilateral Adie's tonic pupil and viral hepatitis: Report of two cases |
title_sort |
unilateral adie's tonic pupil and viral hepatitis: report of two cases |
publisher |
Serbian Medical Society |
series |
Srpski Arhiv za Celokupno Lekarstvo |
issn |
0370-8179 2406-0895 |
publishDate |
2015-01-01 |
description |
Introduction. Adie’s (tonic) pupil is a neuro-ophthalmological disorder
characterized by a tonically dilated pupil, which is unresponsive to light.
It is caused by damage to postganglionic fibers of the parasympathetic
innervation of the eye, usually by a viral or bacterial infection. Adie’s
syndrome includes diminished deep tendon reflexes. Outline of Cases. We
report data of a 59-year-old female with unequal pupil sizes. She complained
of blurred vision and headache mainly while reading. She had a 35-year
history of hepatitis B and liver cirrhosis. On exam, left pupil was mydriatic
and there was no response to light and at slit lamp we saw segments of the
sphincter constrict. We performed 0.125% pilocarpine test and there was a
remarkable reduction of size in the left pupil. The second case is a
55-year-old female who was referred to the University Eye Clinic because of a
headache and mydriatic left pupil. She had diabetes mellitus type 2, as well
as hepatitis A virus 20 years earlier. On exam, the left pupil was mydriatic,
with no response to light. Test with diluted pilocarpine was positive.
Neurological examinations revealed no abnormality in either case so we
excluded Adie’s syndrome. Conclusion. Adie’s tonic pupil is benign
neuro-ophthalmological disorder of unknown etiology. Most patients commonly
present no symptoms and anisocoria is noticed accidentally. Although the
etiology is unknown, there are some conditions that cause tonic pupil. It may
be a part of a syndrome in which tonic pupil is associated with absent deep
tendon reflexes. |
topic |
Adie’s tonic pupil viral hepatitis Adie’s syndrome |
url |
http://www.doiserbia.nb.rs/img/doi/0370-8179/2015/0370-81791508451K.pdf |
work_keys_str_mv |
AT karadzicjelena unilateraladiestonicpupilandviralhepatitisreportoftwocases AT jakovicnatalija unilateraladiestonicpupilandviralhepatitisreportoftwocases AT kovacevicigor unilateraladiestonicpupilandviralhepatitisreportoftwocases |
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