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Topic: Argyll Robertson pupils

	Locomotor Ataxia - LoveToKnow 1911
		In 1869 Argyll Robertson discovered that the eye-pupil is inactive to light but acts upon accommodation in the great majority of cases.
		This most important sign is named the "Argyll Robertson pupil." With an ever-increasing knowledge of the widespread character of this disease and its manifold variations in the complex of symptoms, the tendency among neurologists is to revert to the term employed by Romberg - tabes dorsalis.
		If a physician examines him he will almost certainly find the knee-jerks absent and Argyll Robertson pupils present; probably on inquiry he will ascertain that the patient has had some difficulty in starting urination, or that he is unable to retain his water or to empty his bladder completely.
	www.1911encyclopedia.org /Locomotor_Ataxia (535 words)

	eMedicine - Anisocoria : Article by Eric R Eggenberger
		It is extremely rare for the pupil to be affected in isolation, and, accordingly, it is important to examine patients with anisocoria for dysmotility.
		An Adie pupil is the prototype tonic pupil.
		The pupil reacts vigorously to near stimuli, constituting one of the near-light dissociation syndromes.
	www.emedicine.com /oph/topic160.htm (2363 words)

	Ophthalmologist and eponyms - Douglas Moray Cooper Lamb ARgyll Robertson
		Argyll Robertson's syndrome = A frequent symptom of neurosyphilis, especially tabes dorsalis, and other diseases of thecentral nervous system, in which the pupil is small and responds slowly or not at all to light, but reaction to accommodation and convergence is retained.
		Miotic, irregular pupils without reaction to light were known in singular cases of tabes dorsalis and paralysie générale since the end of the eighteenth century.
		Douglas Moray Cooper Lamb Argyll Robertson was born in 1837 in Edinburgh, where his father, John Argyll Robertson, was a general surgeon, with a special interest in surgery of the eye.
	www.mrcophth.com /ophthalmologyhalloffame/argyllrobertson.html (1231 words)

	EyeNet Magazine Online \| April 2002 \| Ophthalmic Pearls
		Pupil dilation may be the only sign of partial oculomotor palsy (third nerve palsy) in some clinical scenarios, such as basal meningitis.
		The affected pupil reacts poorly to light and better to near stimulus, although the reaction is slow and tonic.
		The affected pupil dilates poorly in response to cocaine 4 to 10 percent.
	www.aao.org /aao/news/eyenet/archive/04_02/perls.html (761 words)

	Argyll Robertson pupil - Wikipedia, the free encyclopedia
		Specifically, the AR pupil is thought to be caused by selective damage to pathways from the retina to the Edinger-Westphal nucleus.
		The evidence supports a midbrain cause of the AR pupil, provided one follows Loewenfeld’s definition of the AR pupil as small pupils that react very poorly to light and yet seem to retain a normal pupillary near response that is definitely not tonic.
		To settle the question of whether the AR pupil is of central or peripheral origin, it will be necessary to perform iris transillumination (or a magnified slit-lamp examination) in a substantial number of patients who have a pupillary light-near dissociation (with and without tonicity of the near reaction), perhaps in many parts of the world.
	www.enpsychlopedia.com /psypsych/Argyll-Robertson_pupil (1027 words)

	Five main causes of light-near dissociation covered Expert explains how this response is relevant to all pupillary ...
		She explained further that patients with afferent visual loss may have unilateral or bilateral deafferented pupils when the lesion is proximal to the lateral geniculate nuclei.
		The pupils in the dorsal midbrain syndrome are midposition or large," she said.
		She showed a patient with a unilateral tonic pupil that was large, irregular, and unreactive to light and responded well to near.
	www.encyclopedia.com /doc/1G1-121931268.html (1054 words)

	News \| Gainesville.com \| The Gainesville Sun \| Gainesville, Fla. (Site not responding. Last check: )
		Argyll Robertson pupils ('AR pupils') are bilateral small pupils that constrict when the patient focuses on a near object (they 'accommodate' with near vision), but do not constrict when exposed to bright light (they do not 'react' to light).
		Adie 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).
		Specifically, the AR pupil is thought to be caused by selective damage to pathways from the retina to the Edinger-Westphal nucleus.
	www.gainesville.com /apps/pbcs.dll/section?category=NEWS&template=wiki&text=Argyll-Robertson_pupil (622 words)

	Adie's Pupil Information on Healthline
		Adie's pupil is a neurological condition of unknown origin with an unusual, asymmetric presentation known as anisocoria, an inequality in the size of the pupils of the eyes.
		For a person with Adie's pupil, however, nerve signals arriving at the ciliary body of one eye are weaker than to the other eye, believed to be a result of damage to or degeneration of the ciliary ganglion or the ciliary body.
		An examination of the eye using a "slit lamp"—an intensely bright lamp shielded by a shade with a slit it it—reveals undulating, irregular, worm-like movements with a segmented or ratcheted appearance in the iris of the affected eye, uncoupled to movements in the iris of the unaffected eye.
	www.healthline.com /galecontent/adies-pupil (1024 words)

	Glossary
		Pupil: The round hole in the centre of the iris that corresponds to the lens aperture in a camera.
		The pupil varies in size according to whether the environment is bright (small pupil) or dark (large pupil).
		Synechiae: Adhesion of the iris to the cornea (anterior synechiae) or the pupil to the lens (posterior synechiae).
	www.cochraneeyes.org /glossary.htm (3634 words)

	Ophthalmic Hyperguide. Neuro-ophthalmology: The Pupil
		When the entire three-neuron sympathetic pathway to the pupil is intact, the resting tonus of the dilator muscle is maintained by a continuous balance between release and reuptake of norepinephrine.
		Although afferent pupil defects are usually considered to be characteristic of optic nerve disease, this sign may also be present in retinal lesions including detachment, age-related macular degeneration, histoplasmosis, and retinal vein occlusion.
		As noted earlier, pupils in patients with preganglionic and central lesions dilate normally to hydroxyamphetamine, and clinical criteria must be used to differentiate the two.
	www.ophthalmic.hyperguides.com /Tutorials/neuro/pupil/tutorial.asp (7045 words)

	Anisocoria for medical students & primary care physician
		Pupils are assymetrical, irregular, and react poorly to light but constrict normally to a near stimulus.
		Pupil is fixed and dilated with poor response to light and near.
		Exam reveals an edematous cornea, IOP is elevated, pupil is fixed mid-dilated, and gonioscopy reveals a closed angle.
	www.eyeweb.org /anisocoria.htm (431 words)

	Pacific Optometry Continuing Education Keratoconus Caroline
		Examination of the pupils is one of the most important neuro-ophthalmologic testing that evaluates the integrity of the anterior visual pathways (afferent) and the autonomic nervous system: parasympathetic (efferent pupillary pathways) and sympathetic pathways (oculosympathetic).
		Near reflex fibers bypass the pretectal nuclei in the dorsal midbrain and synapse to the oculomotor nucleus and the Edinger-Westphal nucleus, causing a light-near dissociation.
		Pupillary Light-Near Dissociation and the Argyll Robertson Pupil
	www.opt.pacificu.edu /ce/catalog/pupil_anomalies/index.html (7647 words)

	1561-MEIS.htm (MEIS-A) (Site not responding. Last check: )
		: tonic pupil, usually unilateral condition of the eye in which the affected pupil is larger than the other, responds to accommodation and convergence in a slow, delayed fashion, and reacts to light only after prolonged exposure to dark or light.
		A dilated pupil slow to react to anything, the Adie's tonic pupil, is almost the reverse of Argyll's pupil, which is a contracted pupil slow to react to light but yes, still reacting to accomodation for near.
		Argyll's pupil, a contracted pupil slow to react to light but yes, still reacting to accomodation for near, is the clinical reverse of a dilated pupil slow to react to anything, the Adie's tonic pupil.
	www.iris-ward.com /_HTM/MEIS/A/1561-MEIS.htm (899 words)

	aniso (Site not responding. Last check: )
		The function of the pupil is to determine how much light is allowed to enter the eye for good vision.
		In bright light the pupils are small, prohibiting stray light and glare from entering the eye.
		A pupil which doesn't get smaller in bright light light but does on near vision is termed an "Argyll Robertson" pupil, for the gentleman who first documented it.
	www.drjeffclark.com /pupils.htm (642 words)

	Marcus Gunn, Argyll Robertson
		Argyll Robertson pupils are pupils that are unreactive to light, but constrict in the near response.
		Argyll Robertson pupils may be seen in patients with Tabes dorsalis (caused by neurosyphilis) or in patients with diabetes mellitus.
		In these patients, the pupil will be dilated on the affected side and will not constrict in response to light presented to either eye or in the near response.
	www.prep4usmle.com /forum/thread/16306 (416 words)

	CNRI.EDU - Iridology - IridoDiagnostic Research and Development Portal
		Although tonic pupils tend to become small and bilateral, they should be distinguished readily from Argyll Robertson pupils, which react briskly, not tonically, to near stimuli.
		Sundaram MB Pupils in congenital neurosyphilis differ from the classic Argyll-Robertson pupil in acquired cases, and often tend to be large and unreactive.
		The Argyll Robertson (AR) pupil has been defined as a pupil that is small and constricts poorly to direct light but briskly when a target within reading distance is viewed ("light-near dissociation").
	cnri.edu /content.asp?contentid=1054 (899 words)

	Reference.com/Encyclopedia/Eye examination
		An examination of pupilary function includes inspecting the pupils for equal size (1 mm or less of difference may be normal), regular shape, reactivity to light, and direct and consensual accommodation.
		If there is an afferent defect in the left eye, both pupils will dilate when the light is shining on the left eye, but both will constrict when it is shining on the right eye.
		If there is a small, irregular pupil that constricts poorly to light, but normally to accommodation, this is an Argyll Robertson pupil.
	www.reference.com /browse/wiki/Eye_examination (1394 words)

	Pupils
		The resting size of each pupil and their respective responses to light shone through them are the best indicators of the status of a patient's brain.
		The pupil is the opening into the eyeball through which light passes to reach the retina and stimulate the neural pathways of visual perception.
		The nerve that enlarges the pupil comes from the sympathetic nervous system that controls the "fight or flight" response to stressful and/or dangerous situations (when people are afraid thier pupil actually becomes larger).
	uscneurosurgery.com /infonet/glossary/p/pupils.htm (497 words)

	Anisocoria - Dr Urvashi Sharma - Jabalpur Divisional Ophthalmic Society (Site not responding. Last check: )
		Argyll Robertson pupil - Tertiary syphilis; the pupil is irregular in shape, reacts poorly or not at all to light, constricts normally during convergence.
		Adie's tonic pupil (the pupil is irregular, reacts minimally to light and slowly to convergence, but is supersensitive to weak cholinergic agents like pilocarpine 0.125%).
		The pupils are tested with one drop of pilocarpine 0.125%; If the pupil contricts significantly more than the normal pupil in 10 to 15 minutes an Adie's tonic pupil is diagnosed.
	www.jdosmp.org /anisocoria.htm (1667 words)

	Symptoms: Symptoms and Diagnosis of Eye Disorders: Merck Manual Home Edition
		Pupil Size: Normally, both pupils (the fl area in the middle of the iris) are the same size.
		Pupils become large (dilate) in the dark and become small (constrict) in bright light.
		Unequal pupils (one large and one small) may be caused by conditions that affect one eye differently than the other.
	www.merck.com /mmhe/sec20/ch225/ch225b.html (3580 words)

	Chapter 25: Metabolic encephalopathy
		Pupils 1 mm in diameter that constrict consensually to bright light.
		With the exception of a few rare conditions (e.g., the Argyll Robertson pupils of tertiary syphilis or advanced diabetes), 1 mm pupils react to light.
		Involvement of the midbrain (midposition and fixed pupils) would have occurred as part of the rostrocaudal process with the exception of the rare intraventricular hemorrhage phenomenon described earlier.
	www.dartmouth.edu /~dons/part_2/chapter_25.html (6964 words)

	HotBot Web Search for pupil
		The pupil is the opening in the center of the iris.
		The size of the pupil determines the amount of light that enters the eye.
		The pupil is the fl part in the center of the eye through which light passes.
	www.hotbot.com /inderelated10index.php?query=pupil (237 words)

	DoctorGeorge.com - Your Family Doctor on the Web
		Normal pupil size is two to three mm.
		This is done by comparing the reactions of the pupils as light is moved from one eye to the other.
		Physiologic anisocoria is a common cause of unequal pupils that react normally.
	www.doctorgeorge.com /article.php?sid=740 (1202 words)

	Argyll Robertson pupil
		Argyll Robertson pupils are small, unequal, irregularly shaped pupils that constrict with accommodation but do not react normally to light.
		This means that while the eyes can focus on objects both near and far, the direct and consensual response to light are reduced or absent.
		These are usually, but not always caused by central nervous system complications of tertiary syphilis (the symptom was formerly known as "prostitute's pupil").
	www.eyes-lasik.com /argyll-robertson-pupil.htm (78 words)

	Alcmeón - Revista Argentina de Clínica Neuropsiquiátrica - Los movimientos oculares en la práctica ...
		We make a review of the anatomy and physiology of the pupils, the influence of systemic agents producing mydriasis and miosis and the occurrence of pupillary changes in relation with nervous and mental diseases.
		The Pupil: Embriology, Anatomy, Innervation and Reflex Movements of the Iris.
		Pupil response to intravenous heroin (diamorphine) in dependent and non-dependent humans.
	www.alcmeon.com.ar /8/29/Ure.htm (2939 words)

	Quia - AA HA Chapter 12 EYES
		Pupil shape may be irregular frm swelling of iris.
		Enlarged pupils occur w/ stimulation of the symp.
		Usually unilateral, a large regular pupil that does not react.
	www.quia.com /jg/337645list.html (705 words)

	Introduction: Neuro-ophthalmologic and Cranial Nerve Disorders: Merck Manual Professional
		Neuro-ophthalmologic disorders involve the eye, pupil, optic nerve, extraocular muscles and their nerves, or the central pathways that control and integrate ocular movement and vision.
		Normally, the pupils constrict promptly (within 1 sec) and equally during accommodation and during exposure to direct light and to light directed at the other pupil (consensual light).
		If a pupil constricts in response to consensual but not to direct light and paradoxically enlarges when light is quickly brought from the unaffected side, the defect is afferent (called Marcus Gunn pupil).
	www.merck.com /mmpe/print/sec16/ch219/ch219a.html (914 words)

	Review of Optometry October 1999 Therapeutic Drugs
		This will be in stark contrast to the bilateral pupil sluggishness you'll see when you shine a light into either eye alone, or into both eyes together.
		Often referred to as a "dissociated pupil response" (strong to near; poor to light), you'll also observe this in cases of neuro-syphilis with Argyll Robertson pupils.
		You may suspect bilateral optic nerve disease if the swinging-flashlight test reveals all these findings: Pupils seem relatively normal in size and shape; the patient's brightness sense is down; color sensitivity is bilaterally poor; acuity is down or "not quite right" in both eyes; and optic disc colorations are suspicious.
	www.revoptom.com /archive/issue/ro101f3.htm (1599 words)

	Oculomotor Nerve (Cr N III)
		The mechanism by which this phenomenon occurs is thought to be by a reduction in the number of fibers subserving the light reflex on the affected side.
		The Marcus-Gunn pupil is caused by optic nerve or chiasm damage as is seen with multiple sclerosis and lesions compressing the optic nerve.
		But in the denervated pupil, post-denervation hypersensitivity (enzyme depletion) allows the pupillo-constrictor effect to be seen.
	www.ucsf.edu /nreview/02.2-Anatomy-CranialNerves/CN03-oculomotor.html (1470 words)

	Adie's syndrome (www.whonamedit.com)
		Notes on a peculiar pupil phenomenon in two cases of partial iridoplegia.
		A propos d’un cas de réaction tonique d’une pupille a la convergence et parésie de l’accommodation avec aréflexie a la lumière chez un sujet atteint de crises tétaniformes et d’aréflexie des membres inférieurs.
		Tonic pupils and absent tendon reflexes: a benign disorder sui generis: its complete and incomplete forms.
	www.whonamedit.com /synd.cfm/1837.html (500 words)

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