Monday, 18 October 2010

MRCP revision battle 33.8: Holmes Adie pupil

Holmes-Adie pupil is a dilated (myotonic) pupil.

It is a benign condition.

Females (70%) > males (20%)
Unilateral in 80% of cases

A Holmes-Adie pupil is sluggish to accomodate and reacts poorly, if at all, to light.

If a Holmes-Adie pupil is associated with absent leg reflexes it is known as Holmes-Adie Syndrome.

Since that was such a short battle lets just throw in a quick recap of the diferentials for a dilated pupil:
  • third nerve palsy
  • drugs
    • antidepressants
    • amphetamines
    • atropine
    • tropicamide
  • Holmes-Adie
  • trauma - sphincter pupillae rupture