Why does Argyll Robertson pupil happen?

Argyll Robertson pupil is found in late-stage syphilis, a disease caused by the spirochete Treponema pallidum. Neurosyphilis occurs due to an invasion of the cerebrospinal fluid (CSF) by the spirochete which likely occurs soon after the initial acquisition of the disease.

Why Argyll Robertson pupil is small?

The Argyll Roberson pupil is a small, abnormal pupil with impaired pupillary constriction in response to light. Argyll Robertson pupils are usually caused by tertiary syphilis, but they may also be caused by diabetes or multiple sclerosis.

How do you test Argyll Robertson pupils?

A. THE FINDING. Argyll Robertson pupils have four characteristic findings: (1) bilateral involvement, (2) small pupils that fail to dilate fully in dim light, (3) no light reaction, and (4) brisk constriction to near vision and brisk redilation to far vision.

What is pseudo Argyll Robertson pupil?

A pseudo-Argyll Robertson pupil is a neurological sign indicating a normal near reflex but the absence of a light reflex (light-near dissociation), a lack of miosis, and pupil irregularity.

What is a Rapd?

Background. Relative Afferent Pupillary Defect (RAPD) is a condition in which pupils respond differently to light stimuli shone in one eye at a time due to unilateral or asymmetrical disease of the retina or optic nerve (only optic nerve disease occurs in front of the lateral geniculate body).

Does mydriasis cause blurred vision?

Benign episodic unilateral mydriasis (BEUM) is a temporary condition that creates a dilated pupil in only one eye. Often individuals with this condition will also experience a mild headache, eye pain, light sensitivity, and blurred vision during these episodes.

What is Holmes Adie syndrome?

Adie syndrome, or Holmes-Adie syndrome, is a rare neurological disorder affecting the pupil of the eye. In most patients the pupil is larger than normal (dilated) and slow to react in response to direct light. Absent or poor tendon reflexes are also associated with this disorder.

What is Marcus Gunn pupil?

Marcus Gunn pupil (MGP) is the term given to an abnormal pupil showing aberrant pupillary response in certain ocular disorders. In literature, the term is often used synonymously with Marcus Gunn phenomenon or relative afferent pupillary defect (RAPD). [1] After exposure to bright light, a normal pupil constricts.

How do you check Marcus Gunn’s pupil?

The Marcus Gunn pupil can be detected by swinging a flashlight between both eyes. Of course, normally, if you flash light in one eye, both pupils will constrict.

What does no APD mean in ophthalmology?

An Afferent Pupillary Defect (APD) is caused by damage to the neuropathway connecting the eyes and the brain. Your doctor or technician will check for this by shining a handheld light into your eyes and looking for an equal response.

Will mydriasis go away?

Many instances of mydriasis, particularly those caused by a reaction to plants or medication, will go away on their own, often within a few hours or days. Individuals with mydriasis will be extra sensitive to light, as long as their pupils are dilated.

Can glaucoma cause mydriasis?

Mydriasis is a risk factor for angle closure glaucoma in certain individuals. This is most commonly seen in those with “narrow angles”, which refers to an unusually narrow angle between the outer edge of the iris and the cornea (the clear part of the eye that covers the front of the eye).

What causes Argyll Robertson pupils?

Argyll Robertson pupils are usually caused by tertiary syphilis, but they may also be caused by diabetes or multiple sclerosis. Usually, both of an affected individual’s eyes have AR pupils, but the condition may be present in only one eye on rare occasions.

What is the history of AR pupils?

In addition, AR pupils are accompanied with frequent iris atrophy. Douglas Moray Cooper Lamb Argyll Robertson, a Scottish ophthalmologist and surgeon, originally described this abnormal pupil finding in 1868. AR pupils were originally described with neurosyphilis and the finding became a characteristic clinical sign for the disease.

Are Argyll Robertson pupils a sign of diabetic neuropathy?

They are a highly specific sign of neurosyphilis; however, Argyll Robertson pupils may also be a sign of diabetic neuropathy.

Is the AR pupil caused by the midbrain?

The evidence supports a midbrain cause of the AR pupil, provided one follows Loewenfeld’s definition of the AR pupil as small pupils that react very poorly to light and yet seem to retain a normal pupillary near response that is definitely not tonic.