Pseudo-Argyll Robertson Pupil

Pseudo-Argyll Robertson Pupil

A pseudo-Argyll Robertson pupil shows light-near dissociation of pupillary reactions, but, unlike the "true" Argyll Robertson pupil, there is no miosis or pupil irregularity. Indeed the pupil may be dilated (mydriasis) and resemble a Holmes-Adie pupil. The latter may be differentiated on the basis of its response to dilute (0.2%) pilocarpine: Holmes-Adie pupil results from a peripheral lesion and shows denervation supersensitivity constricting with dilute pilocarpine, whereas the pseudo-Argyll Robertson pupil results from a central lesion and does not respond. Pseudo-Argyll Robertson pupil has been reported in:

Diabetes mellitus Multiple sclerosis
Wernicke’s encephalopathy

Sarcoidosis Tumor Hemorrhage
Aberrant oculomotor (III) nerve regeneration Spinocerebellar ataxia type 1 (SCA1)

Cross References

Argyll Robertson pupil; Holmes-adie pupil, Holmes-adie syndrome; Miosis; Mydriasis