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A Case Report: Persistent Idiopathic Adie's Tonic Pupil

Prichilia Sarah Permadi , Anak Agung Mas Putrawati Triningrat, Made Paramita Wijayati, Made Agus Kusumadjaja

Prichilia Sarah Permadi
Ophtalmology Resident Departement of Ophtalmology Universitas Udayana, Sanglah General Hospital, Bali. Email: prichiliasarah@gmail.com

Anak Agung Mas Putrawati Triningrat
Ophtalmology Specialist Departement of Ophtalmology Universitas Udayana, Sanglah General Hospital, Bali

Made Paramita Wijayati
Ophtalmology Specialist Departement of Ophtalmology Universitas Udayana, Sanglah General Hospital, Bali

Made Agus Kusumadjaja
Ophtalmology Specialist Departement of Ophtalmology Universitas Udayana, Sanglah General Hospital, Bali
Online First: December 01, 2020 | Cite this Article
Permadi, P., Triningrat, A., Wijayati, M., Kusumadjaja, M. 2020. A Case Report: Persistent Idiopathic Adie's Tonic Pupil. Bali Journal of Ophthalmology 4(2). DOI:10.15562/bjo.v4i2.64


Background: Adie’s Tonic Pupil is a condition of a tonically dilated pupil, which is unresponsive to bright light followed by moderate responsiveness to accommodation. This condition will resolve with time, ranging from months to years. Some patients may experience increased accommodation for near vision but the pupillary light response does not recover and become persistent after 2 years.

Case Presentation: A 26-year-old female patient showed anisocoric pupil in a response to bright light in the left eye. The size of the pupil is 7 mm with the absence of direct and indirect light reflexes and near reflexes. She was diagnosed with Adie’s tonic pupil. It is found to be persistent in the 3 years of follow up, the involved pupil was showing anisocoria, 5 mm in diameter, poor constriction mechanism in direct, indirect, and near reflexes examinations.

Conclusion: Adie’s tonic pupil is a benign neuro-ophthalmology disorder of unknown etiology. This condition mostly will spontaneously resolve. But, at some patients, it could be persistent, which may be related to degree of myelination of neural fibers.

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