Adie syndrome features a tonically dilated pupil that reacts poorly to light but better to near effort, often with absent deep tendon reflexes. It typically affects young adults and is usually benign.
Eye findings
The affected pupil appears larger and sluggish compared with the other eye.
- Light-near dissociation and segmental sphincter constriction
- Supersensitivity to dilute pilocarpine drops
- Possible difficulty with near focus and glare
- May be unilateral or become bilateral over time
Management
Treatment focuses on symptom relief.
- Reading glasses or low-dose pilocarpine for near difficulties
- Tinted lenses for photophobia
- Neurology review if other neurological signs are present
- Reassurance that the condition is generally stable and non-progressive
