---
title: Argyll robertson pupil
description: "An Argyll Robertson pupil is small, irregular, and reacts poorly to light but constricts normally for near focus. It is classically associated with neurosyphilis. ## Characteristics The key feature is light-near dissociation. - Bilateral miotic pupils with minimal or absent…"
url: "https://bluefinvision.com/knowledge-base/topics/conditions-diseases/argyll-robertson-pupil/"
updated: "2025-12-17"
category: "Conditions & Diseases"
---

# Argyll robertson pupil

An Argyll Robertson pupil is small, irregular, and reacts poorly to light but constricts normally for near focus. It is classically associated with neurosyphilis.

## Characteristics

The key feature is light-near dissociation.

- Bilateral miotic pupils with minimal or absent response to direct and consensual light
- Preserved constriction during accommodation and convergence
- Often accompanied by other neurological signs of dorsal midbrain or syphilitic damage
- Syphilis serology and neuroimaging help confirm the underlying cause

## Management

Treatment focuses on the underlying disease.

- Appropriate antibiotic therapy for neurosyphilis after infectious disease consultation
- Neurological assessment for additional deficits
- Monitoring of visual function and fields
- Pupil changes themselves are usually permanent even after treatment