Adie

Adie syndrome is a neurological disorder characterized by a tonic pupil that reacts slowly to light but reacts normally to accommodation (i.e., it constricts when focusing on a near object and dilates when focusing on an object in the distance). This condition is also associated with absent or diminished deep tendon reflexes, such as the Achilles reflex. The syndrome is named after William John Adie, a British neurologist who first described it in 1931.

Signs and symptoms

The most common symptoms of Adie syndrome include blurred vision and problems with light adaptation due to the abnormal pupil reaction. Some patients may also experience difficulty reading. The diminished deep tendon reflexes are usually found in the lower limbs but can also occur in the upper limbs. Other less common symptoms include sweating abnormalities and tremor.

Causes

The exact cause of Adie syndrome is unknown. However, it is believed to be due to damage to the postganglionic fibers of the parasympathetic innervation to the eye, likely due to an autoimmune or infectious process. Some studies have suggested a possible association with herpes simplex virus.

Diagnosis

Diagnosis of Adie syndrome is primarily based on clinical findings. The pilocarpine test can be used to confirm the diagnosis. In this test, a weak solution of pilocarpine is applied to the eye. In a normal eye, this would have little or no effect, but in an eye with Adie syndrome, the pupil will constrict.

Treatment

There is no cure for Adie syndrome, but the symptoms can be managed. Glasses with photochromic lenses can help with light sensitivity and reading difficulties. In some cases, a drug called mestinon (pyridostigmine) can be used to improve the speed of pupillary constriction.

See also

• Holmes-Adie syndrome
• Ross syndrome
• Harlequin syndrome

References

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