A Case of Adie's Tonic Pupil Before Presentation of Denervation Hypersensitivity.

Lee, Kyu Sung; Choi, Hyun Jun; Kim, Hye Young

doi:2008.49.12.2032

J Korean Ophthalmol Soc > Volume 49(12); 2008 > Article

Case Report

Journal of the Korean Ophthalmological Society 2008;49(12):2032-2036.
DOI: https://doi.org/10.3341/jkos.2008.49.12.2032 Published online December 15, 2008.

A Case of Adie's Tonic Pupil Before Presentation of Denervation Hypersensitivity.

Kyu Sung Lee, Hyun Jun Choi, Hye Young Kim

National Health Insurance Corporation Ilsan Hospital, Gyeonggi, Korea. khyeye@hanmail.net

탈신경 과민반응 발현 이전의 에이디 긴장성 동공 1예

이규성ㆍ최현준ㆍ김혜영

National Health Insurance Corporation Ilsan Hospital, Gyeonggi, Korea

Abstract

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.

Key Words: Denervation hypersensitivity;Tonic pupil