II. Pathophysiology

  1. Normal variant
  2. May be seen in younger persons with widened pupils

III. Signs

  1. Sluggish pupil reaction with prolonged latency
  2. May be unilateral

IV. Diagnosis

  1. Differentiate from Argyll Robertson Pupil
  2. Tonic pupil dilates with Atropine

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Ontology: Tonic Pupil (C0040416)

Definition (MSH) A pupillary abnormality characterized by a poor pupillary light reaction, reduced accommodation, iris sector palsies, an enhanced pupillary response to near effort that results in a prolonged, "tonic" constriction, and slow pupillary redilation. This condition is associated with injury to the postganglionic parasympathetic innervation to the pupil. (From Miller et al., Clinical Neuro-Ophthalmology, 4th ed, pp492-500)
Concepts Sign or Symptom (T184)
MSH D015845
ICD9 379.46
ICD10 H57.05
SnomedCT 123051004, 155204008, 267749005, 24225004
English Pupil, Tonic, Pupils, Tonic, Tonic Pupils, Pupillotonia, Adie's pupil (physical finding), accommodation Adie's pupil (large, slowly reactive), Adie's tonic pupil, Adie's tonic pupil (diagnosis), the pupils reacted sluggishly but completely to light, Pupil Adie's, Adie's Pupil, Adies Pupil, Pupil, Adie's, Myotonic Pupil, Myotonic Pupils, Pupil, Myotonic, Pupils, Myotonic, Pupillotonias, Tonic Pupil [Disease/Finding], adie pupil, adies pupils, adie's pupil, tonic pupil, adies pupil, tonic pupils, Pupils, Adie's, Pupillatonia, Adie Pupil, Pupil, Adie, Adie pupil, Adie's pupil, Tonic pupillary reaction, Tonic pupil, Myotonic pupil, Holmes-Adie pupil, Tonic pupillary reaction (disorder), pupillotonia, Adie's pupil -RETIRED-, Tonic Pupil
Italian Pupilla di Holmes-Adie, Reazione tonica della pupilla, Pupilla di Adie, Pupillotonia, Pupilla miotonica, Pupilla tonica
Dutch pupil van Adie, tonische pupilreactie, pupilatonie, Holmes-Adie-pupil, pupillotonie, Adie, syndroom van, Pupillotonie, Tonische pupil
French Réflexe pupillaire tonique, Atonie pupillaire, Pupille d'Adie Holmes, Pupille tonique, Pupillotonie, Pupille d'Adie
German tonische Pupillenreaktion, Adie-Syndrom, Pupille, tonische, Pupillotonie, Adie-Pupille
Portuguese Reacção pupilar tónica, Pupila de Holmes-Adie, Pupilotonia, Pupila de Adie, Pupila Tônica
Spanish Pupilatonia, Reacción pupilar tónica, pupila de Adie - RETIRADO - (concepto no activo), pupila de Adie - RETIRADO -, pupila de Adie, pupila miotónica, pupila tónica, pupilotonía, reacción pupilar tónica (trastorno), reacción pupilar tónica, Pupila de Holmes-Adie, Pupilotonía, Pupila de Adie, Pupila Tónica
Japanese ホームズ・アディー瞳孔, 緊張性瞳孔反応, アディードウコウ, ホームズアディードウコウ, ドウコウキンチョウ, キンチョウセイドウコウハンノウ, Adie瞳孔, 瞳孔緊張症, アディー瞳孔, 瞳孔強直, 瞳孔緊張, 緊張性瞳孔, 瞳孔-緊張性
Swedish Tonisk pupill
Czech tonická pupila, Adieho pupila, pupila strnulá, Holmes-Adieho zornice, Tonická pupilární reakce, Pupilotonie
Finnish Tooninen pupilli
Russian ZRACHOK TONIZIROVANNYI, ZRACHKA NEIROTONICHESKAIA REAKTSIIA, EIDI ZRACHOK, ZRACHOK RASSHIRENNYI, PIL'TTSA REFLEKS, RASSHIRENNYI ZRACHOK, VESTFALIA-PIL'TTSA REFLEKS, TONIZIROVANNYI ZRACHOK, ВЕСТФАЛЯ-ПИЛЬТЦА РЕФЛЕКС, ЗРАЧКА НЕЙРОТОНИЧЕСКАЯ РЕАКЦИЯ, ЗРАЧОК РАСШИРЕННЫЙ, ЗРАЧОК ТОНИЗИРОВАННЫЙ, ПИЛЬТЦА РЕФЛЕКС, РАСШИРЕННЫЙ ЗРАЧОК, ТОНИЗИРОВАННЫЙ ЗРАЧОК, ЭЙДИ ЗРАЧОК
Polish Objaw Adiego, Sztywność źrenic
Hungarian Pupillotonia, Adie pupilla, Pupillatonia, Tonusos pupilla reakció, Holmes-Adie-pupilla
Norwegian Tonisk pupill, Adies pupill, Adies toniske pupill, Pupillotoni, Myotonisk pupill