Rigid pupils, reflective A52.1

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Argyll-Robertson pupil; Argyll-Robertson's pupil rigidity; reflective; Rigidity of the pupil; Rigid pupil tabular reflex; table

History
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Robertson, 1869

Definition
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Absence of direct and consensual light response, narrow pupils (irritant diosis), excessive close-up reaction (pupil constriction in convergence).

Notice! Pathognomonic for Tabes dorsalis in syphilis IV.

Etiopathogenesis
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Mostly in syphilis cerebrospinalis, but also in chronic alcoholism, traumatic brain lesions and epidemic encephalitis, also occurring in multiple sclerosis and other cerebral diseases.

Clinical features
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Cancellation of the direct and consensual light reflex of the pupil with preserved reflex on accommodation and convergence; pupil reaction to sensory and psychological stimuli is absent or reduced; anisocoria, often also rounding of the pupil.

Therapy
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Literature
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  1. Robertson A (1869) Four cases of spinal miosis; with remarks on the action of light on the pupil. Edinburgh med J 15: 487-493
  2. Robertson A (1869) On an interesting series of eye symptoms in a case of spinal disease, with remarks on the action of belladonna on the iris etc. Edinburgh med J 14: 646-708

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Last updated on: 29.10.2020