---
title: Adie syndrome (tonic pupil)
description: "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…"
url: "https://bluefinvision.com/knowledge-base/topics/conditions-diseases/adie-syndrome-tonic-pupil/"
updated: "2025-12-16"
category: "Conditions & Diseases"
---

# Adie syndrome (tonic pupil)

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