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Argyll Robertson pupils

Description

A reflex iridoplegia characterized by small, irregular, unequal pupils, with near-light dissociation; absence of a miotic reaction to both direct and consensual light with preservation of the accommodation reflex. Classically associated with neurosyphilis. Rare since the advent of penicillin. Most often found on Medical school exams…

Other causes of reflex iridoplegia include Holmes-Adie syndrome, Parinaud syndrome, diabetic neuropathy, brain injury, thiamine deficiency, and mitral regurgitation.


History

1869Argyll Robertson published his ocular clinical findings of four patients with a spinal disease, now known to be neurosyphilis, in the Edinburgh Medical Journal

I could not observe any contraction of either pupil under the influence of light, but, on accommodating the eyes for a near object, both pupils contracted.

[1869;14:696–708]

Although it was many years and required the contribution of multiple physicians including Wilhelm Erb of Heidelberg (1881), Babinski and Charpentier (1899) and finally confirmed by the discovery of the Wassermann reaction (1906) that the association with syphilis was widely accepted.

The anatomy and physiology were not well defined and Argyll Robertson never taught that the disease was pathognomonic for neurosyphilis, however, if found it needs to be excluded.


Associated Persons


Alternative names

  • Prostitute’s pupils
  • AR pupils

References


eponymictionary CTA

eponymictionary

the names behind the name

Physicianly type with neurological leanings... | LinkedIn |

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