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What is Adie Syndrome?

By Debra Durkee
Updated May 17, 2024
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Adie syndrome is a condition in which the pupils of an individual's eyes are permanently dilated. In this state, the eye cannot react as well to changes in light. Other reflexes, such as those of the knee and other tendons, can also be delayed. A very rare condition, Adie syndrome is not life-threatening, and afflicted individuals can live comfortably with the condition for a long time. Adie syndrome is also known as tonic pupil syndrome, Holmes-Adie syndrome, papillotonic psuedotabes, Pseudo-Argyll Robertson syndrome, Weill-Reys syndrome, or Adie's tonic pupil.

In addition to the dilated pupils and slowed reflexes of large tendons like the Achilles tendon, those who have Adie syndrome are typically sensitive to bright lights. Their pupils react slowly to changes in light, and are slow to focus on objects of varying distances because of damage or a malfunction in the ciliary bodies of the eye that control the pupil. Other symptoms include a rise or drop in blood pressure when standing suddenly, patches of the skin where the body does not sweat, and an irregular heartbeat. Occasionally, individuals are seen with abnormally constricted pupils instead of pupils that are dilated, although the rest of the symptoms associated with this are the same.

Almost three times as common in women as in men, the causes of Adie syndrome are unknown. It is thought to be related to other nervous system diseases or autoimmune responses, and has been seen to develop in those who also suffer from migraines or excessive sweating. It has also been suggested that there is a link between Adie syndrome and caffeine use, sugar consumption, a viral infection, or trauma to the eye. The most common sufferers are young women between 20 and 40 years old.

Testing for Adie syndrome involves an eye exam to determine the responsiveness of the pupil. Medical professionals may include other tests to rule out a different diagnosis. Intense reactions to eyedrops can also help determine the diagnosis, as this indicates a malfunction in control of eye movement.

Typically, only one eye in affected during the onset, but the condition usually spreads to the other eye. The condition of having one pupil larger than the other is called anisocoria. The loss of reflexive movement in the tendons is permanent, but there are drops that can be used to aid in the constriction of the afflicted pupils. Prescription glasses can be tailored to aid in clearing any vision problems associated with the condition.

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