Adies (tonic) Pupil

Your Path

  • Adies (tonic) pupil


  • Loss of parasympathetics to muscles of pupilary constriction
  • Idiopathic or related to injury, infection, tumor


  • Unilateral dilated pupil
  • Difficulty focusing on objects

Physical Exam Findings

  • Dilated pupil
  • Normal EOMs
  • Opposite eye nl
  • Poorly/unreactive to direct or indirect light
  • Subtle pupillary constriction when viewing close objects