Adies syndrome

Friedman, E.D.

Arch Ophthalmol: 1042-1068


DOI: 10.1097/00005053-193610000-00036
Accession: 024195672

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Fourteen cases of Adie's syndrome were studied by pupillographic and phar-macodynamic methods. Two types of pupillotonic reactions are differentiated, one of which is caused by peripheral lesions within the 3d nerve, and the other by lesions within the great vegetative centers of the diencephalon and their connections with the mesencephalon. Only the latter type constitutes a true Adie's Syndrome. It is an heredo-degenerative condition. Physostigmine contracts the Adie pupil like the normal pupil; however, it restores the ability of the normal pupil to react to light and to dilate to distant vision (in 12-20 mins. after its local application). This physostigmine test enables one to differentiate between Adie's Syndrome and similar syndromes due to acquired syphilitic infections. Pupillotonic pseudo-tabes and neuro-tonia, characterized by a prompt contraction of the pupil to light but sluggish and retarded dilation, and by unilaterally or bilaterally diminished or absent convergence reaction, form a clinical entity and may be substituted for one another in the hereditary sequence.