- Adie syndrome
Name = Adie syndrome
DiseasesDB = 29742
ICD9 = ICD9|379.46
MeshID = D015845
Adie syndrome, sometimes known as Holmes-Adie's syndrome or Adie's Tonic Pupil, is a
neurological disorderwhich affects the pupilof the eye and the autonomic nervous system.cite web |url=http://www.ninds.nih.gov/disorders/holmes_adie/holmes_adie.htm |title= Holmes-Adie syndrome Information Page | author= |publisher=National Institute of Neurological Disorders and Stroke|accessdate=2008-01-21 |format= |work=] It is caused by damage to the postganglionic fibers of the parasympathetic innervation of the eye, usually by a viralor bacterialinfection which causes inflammation, and characterized by a tonically dilated pupil.
igns and Symptoms
Adie syndrome presents with three
hallmarksymptoms, namely abnormal pupil size ( mydriasis), loss of deep tendon reflexes and diaphoresis. Other signs may include hyperopiadue to accommodative paresis, photophobiaand difficulty reading.cite book | last = | first = | authorlink = | coauthors = | title = Stedman's Medical Dictionary, 27th Edition | publisher = | date = 2000 | location = | pages = | url = | doi = | id = | isbn = 0-683-40007-X]
Clinical exam may reveal sectoral paresis of the iris sphincter and/or vermiform iris movements. The tonic pupil may become smaller (miotic) over time which is referred to as "little old Adie's".cite book | last = Haines | first = Duane E. | authorlink = | coauthors = | title = Fundamental Neuroscience, 2nd edition | publisher = | date = 2002 | location = | pages = | url = | doi = | id = | isbn = 0-443-06603-5] Testing with low dose (1/8%)
pilocarpinemay constrict the tonic pupil due to cholinergicdenervation supersensitivity. A normal pupil will not constrict with the dilutedose of pilocarpine. CT scans and MRIscans may be useful in the diagnostic testing of focal hypoactive reflexes.cite web |url=http://www.wrongdiagnosis.com/a/adie_syndrome/diagnosis.htm |title= Diagnosis of Adie syndrome | author= |publisher= WrongDiagnosis.com|accessdate=2008-01-21 |format= |work=]
The usual treatment of a standardised Adie syndrome is to prescribe reading glasses to correct for impairment of the eye(s).
Pilocarpinedrops may be administered as a treatment as well as a diagnostic measure, and should be applied three times daily. Thoracic sympathectomyis the definitive treatment of diaphoresis, if the condition is not treatable by drug therapy.
Adie's syndrome is not life threatening or disabling. As such, there is no mortality rate relating to the condition, however loss of deep tendon reflexes is permanent and may progress over time.
It most commonly affects younger women and is unilateral in 80% of cases.
* [http://oddsnsods.camio.co.uk/node/2 Personal experience]
* [http://www.mrcophth.com/eyeclipartchua/pupils.html Animation] at mrcophth.com
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