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KMID : 0360220080490122032
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Journal of the Korean Ophthalmological Society
2008 Volume.49 No. 12 p.2032 ~ p.2036
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A Case of Adie’s Tonic Pupil before Presentation of Denervation Hypersensitivity
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lee Kyu-Sung
Choi Hyun-Joon
Kim Hye-Young
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Abstract
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Purpose: Denervation supersensitivity to 0.125% pilocarpine is an important factor in making a diagnosis of Adie’s tonic pupil. However, it generally takes several weeks for denervation supersensitivity to manifest after an injury to the nerve ganglion. We report a case of ‘acute’ Adie’s tonic pupil before the manifestation of denervation supersensitivity.
Case summary: A 53-year-old man with no significant past medical history visited our clinic, reporting mydriasis of his left eye. Pupil size was 8 mm in the right eye, 3 mm in the left. Loss of both direct/indirect light reflex and light-near reflex were observed. The left pupil did not react to 0.125% Pilocarpine, but constricted in response to 1% pilocarpine. After 5 months, the pupil size did not change, but the pupil constricted in response to 0.125% pilocarpine.
Conclusions: In an isolated case of dilated pupil, though the pupil did not react to 0.125% pilocarpine, with respect to the Adie’s tonic pupil, to check the manifestation of denervation supersensitivity should be needed at regular intervals.
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KEYWORD
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Denervation hypersensitivity, Tonic pupil
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