A patient whose pupil “accommodates but does not react” almost always has a tonic pupil, not an AR pupil. When penicillin became widely available in the 1940s, the prevalence of AR pupils (which develop only after decades of untreated infection) decreased dramatically. In the early 20th century, Adie described a second type of pupil that could “accommodate but not react.” Adie’s tonic pupil is usually associated with a benign peripheral neuropathy ( Adie syndrome), not with syphilis. The AR pupil became known as a reliable clinical sign of syphilis. When serological tests for syphilis became available, patients with AR pupils usually tested positive for syphilis. The AR pupil was named after Douglas Moray Cooper Lamb Argyll Robertson, a Scottish ophthalmologist who noted the association with syphilis in 1869. There is continued interest in the underlying pathophysiology, but the scarcity of cases makes ongoing research difficult. A video of AR pupils and light-near dissociation is available at ĪR pupils are extremely uncommon in the developed world. Pupils that “accommodate but do not react” are said to show light-near dissociation. They are a highly specific sign of neurosyphilis. They were formerly known as "prostitute's pupils" because of their association with syphilis and because, like a prostitute, they “accommodate but do not react.” ). OverviewĪrgyll Robertson pupils (“AR pupils”) are bilateral small pupils that constrict when the patient focuses on a near object (they “ accommodate” with near vision), but do not constrict when exposed to bright light (they do not “react” to light). List of terms related to Argyll Robertson pupilĮditor-In-Chief: C. Risk calculators and risk factors for Argyll Robertson pupilĬauses & Risk Factors for Argyll Robertson pupilĭiagnostic studies for Argyll Robertson pupilĪrgyll Robertson pupil in the Marketplace Patient Handouts on Argyll Robertson pupilĭirections to Hospitals Treating Argyll Robertson pupil Patient resources on Argyll Robertson pupilĭiscussion groups on Argyll Robertson pupil US National Guidelines Clearinghouse on Argyll Robertson pupilīe alerted to news on Argyll Robertson pupil Ongoing Trials on Argyll Robertson pupil at Clinical Ĭlinical Trials on Argyll Robertson pupil at Google Podcasts & MP3s on Argyll Robertson pupilĬochrane Collaboration on Argyll Robertson pupil Powerpoint slides on Argyll Robertson pupil Review articles on Argyll Robertson pupilĪrticles on Argyll Robertson pupil in N Eng J Med, Lancet, BMJ Most cited articles on Argyll Robertson pupil Most recent articles on Argyll Robertson pupil WikiDoc Resources for Argyll Robertson pupil
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