Consultant Ophthalmologist,
Cataract & Refractive Surgeon

BMedSci BM BS MRCS MRCSEd MRCOpth FRCOphth MMedLaw PgD Cataract & Refractive Surgery

Holmes-Adie Pupil

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What's going on?

This is an internal ocular muscle problem. The parasympathetic supply to the pupilloconstrictor muscle has been interrupted by a presumed viral pathology. The patient's vision may be blurred due to their dilated pupil and poor accommodation.

If I examine the patient, what will I find?

Initially, the pupil is dilated but gradually becomes smaller over time. It is usually poorly reactive to light.

What if I've diagnosed it?

Refer routinely for confirmation of diagnosis.

What will the hospital do?

No need for treatment.