[Tonic pupil, pupil Adie syndrome Adie Holmes: current reassessment of terminology -- a clinical case]

Abstract

The benign syndrome of pupillotonia and absence of deep reflexes is not uncommon. It was clearly and accurately described by Adie (1932), although incompletely recognized many years, before. The pupillary abnormality was reported by ophthalmologists at the turn of the century (Saenger, 1902, Strasburger 1902), and the associated deep reflex change was described by Markus (1906), Roemheld (1921) and Parkes Weber (1923). Holmes (1932) was fully aware of the association of "partial iridoplegia" with diminished reflexes. Tonic pupils react poorly to light but constrict during viewing of a near stimulus. Adie's name is typically used in association with tonic pupils, but a review of Adie's articles reveals that he described the syndrome of tonic pupils and absent reflexes and not the pupillary abnormality per se. Therefore, it would be more appropriate to refer to a tonic pupil as simply a 'tonic pupil" and leave Adie's name for the syndrome. We report a typical case of tonic pupil.