Adie’s pupil is a neurological condition that affects the eye and the autonomic nervous system. It is characterized by anisocoria, an inequality in the size of the pupils of the eyes. The pupil of one eye is larger than normal, and it constricts slowly in bright light, a condition known as tonic pupil.

The condition may progress to the other eye. Other symptoms of this condition may include the loss of some deep tendon reflexes. Adie’s pupil is also referred to as Holmes-Adie syndrome. Adie’s pupil primarily affects young women. It is considered a benign condition with no known cure.

Adie’s pupil is thought to be caused by an infection that damages the neurons in the brain, according to NINDS. A viral or bacterial infection is thought to be the cause of inflammation that damages neurons in the ciliary ganglion and the spinal ganglion. S

Adie’s pupil generally begins gradually in one eye and often progresses to the other eye, according to NINDS. The condition may initially cause the loss of deep tendon reflexes on one side of the body and then progress to the other side.

People may sweat excessively, sometimes sweating on just one side of the body. Adie’s pupil has symptoms that may appear in conjunction with other nervous-symptom conditions such as migraine, according to NINDS.

The diagnosis of Adie’s pupil may include a physical examination to rule out other causes. In most cases, a professional in an optometrist’s or ophthalmologist’s office examines the person. The exam usually includes a test of the eye’s reaction to a diluted amount of pilocarpine drops.

The drops are an alkaloid substance from the jaborandi tree; they cause the otherwise slow-to-constrict pupil to constrict intensely. In a normal eye, the diluted drops would not cause the pupil to constrict.

In addition, the eyes may be examined with a slit lamp, an intensely bright lamp shielded by a shade with a slit. The diagnosis may be based on observing the pupil’s reaction to light and dark conations.

Conventional treatment is necessary for Adie’s pupil. Not much is known about this condition so treatments that strengthen or protect the nervous system might be helpful. These include taking the B-complex of vitamins.

The complex or group consists of nutrients that are useful to the nervous system and eye health. Stress-reducing activities such as yoga or massage may be helpful.

A doctor may prescribe prescription reading glasses to help correct the vision in the affected eye. In addition, the person may find it helpful to wear sunglasses or tinted indoor glasses. The doctor may recommend that the patient apply pilocarpine drops to the eye three times a day. These drops constrict the pupil, making it smaller.

Adie’s pupil is not a disabling or life-threatening condition, according to NINDS. Although some symptoms in the eyes may worsen, the use of glasses and eyedrops will help correct vision problems. However, the loss of the deep tendon reflexes is permanent. No preventative measures have yet been identified.