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Tag Argyll Robertson pupil
Neurological Mind Boggler 340

Coma and small pupils

You are asked to review a 65 year-old man who is comatose (GCS 3) with small pupils (2 mm bilaterally). He has a history of diabetes mellitus and bipolar disorder. He was discharged from hospital yesterday, following a surgical procedure.
eponymictionary-340-256 2

Argyll Robertson pupils

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.