The Holmes-Adie tonic pupil is a widely dilated pupil that reacts slowly to light, but briskly to accomodation. It is found more frequently in females, and is usually unilateral. It is often associated with loss of knee jerks and impairment of sweating. Under normal conditions, methacholine is too rapidly hydrolyzed to have any effect on the normal pupil. A very common cause of pupillary dilatation.
Diphtheria can cause damage to the ciliary nerves and is often seen with palatal paralysis.
An important syndrome caused by a lesion in the sympathetic nervous system pathway affecting pupillary function. Signs and Symptoms 1. A small pupil which reacts normally to light and accomodation. Ptosis to a variable degree. Decreased sweating over forehead.