Eventually, after months or years, the pupil, which was initially larger than the unaffected pupil, will become smaller than the unaffected pupil. This reminds of the movement of an earthworm. If the pupil is observed with a loupe or microscope a typical behavior can be observed both spontaneously or during near response: Some sectors of the sphincter muscles constrict and others don’t.
The pupil will constrict slowly when focusing (=accommodating) on objects close at hand (normally referred to as near response). In many cases it is not ideally round but slightly ovally distorted. In most patients with Adie syndrome the affected pupil is larger than normal (dilated) all the time and does not constrict very much or not at all in response to direct light. The pupil normally opens wider (dilates) in dim light or darkness, when focusing on far away objects, or when a person is excited. Normally the pupil gets smaller (constricts) in the presence of light or when focusing on nearby objects. When a person’s pupils are of unequal size, the term anisocoria may be used. When only abnormalities affecting the pupil are present, the disorder may be referred to as Adie’s pupil, Adie’s tonic pupil or, most commonly, tonic pupil. However, these findings may not develop at the same time. The term Adie syndrome is used when both abnormalities of the pupil and loss of deep tendon reflexes are present. Adie syndrome involves a usually non progressive and limited damage to the autonomic nervous system, which is the portion of the nervous system that controls or regulates certain involuntary body functions including the reaction of the pupils to stimuli. In rare cases localized disturbance of sweat secretion is associated with Adie syndrome (Ross syndrome). In most individuals, the cause is unknown (idiopathic), but Adie syndrome can occur as due to other conditions such as trauma, surgery, lack of blood flow (ischemia) or infection. Absent or poor tendon reflexes are also associated with this disorder. In most patients the pupil is larger than normal (dilated) and slow to react in response to direct light. 5 Myths About Orphan Drugs and the Orphan Drug ActĪdie syndrome, or Holmes-Adie syndrome, is a rare neurological disorder affecting the pupil of the eye.Information on Clinical Trials and Research Studies.Meathmom, I'm sure your dd will be fine - but definitely go to GP for referral to put your mind at rest. I had to keep his eyes shielded from the sun for a few hours afterwards, but he was absolutely fine. The only difficult bit was when the consultant put drops in ds2's eyes at the first appointment - they were to dilate the pupils so he could see into the eyes, and ds2 yelled the place down as he really hated them. No-one else in the family has this, although my side are very short-sighted which made me initially worried. Both dilate and contract normally and he can focus perfectly, it's purely a size difference. He was discharged from consultant last August, aged 3.10, and his sight is absolutely fine - it's just that one pupil happens to be quite a bit larger than the other. I noticed it when he was 4 months, took him to the GP, who referred him to consultant.Ĭonsultant checked him initially, was happy that ds2 was able to follow objects and focus correctly for his age, but kept him on the Opthalmology books until ds was actually able to tell him what he could see. Yes, ds2 has one pupil very noticeably larger than the other.
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