Pathophysiology of Signs Associated with a Tonic Pupil

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Identifier Figure-16
Title Pathophysiology of Signs Associated with a Tonic Pupil
Creator Daniel M. Jacobson, MD (1956-2003)
Affiliation (DMJ) Neuro-Ophthalmologist, Marshfield Clinic, University Iowa College of Medicine, Iowa City, Iowa
Subject Adie's Tonic Pupil; Pupil Disorders; Physiopathology, Iris; Pupil
Description Pathophysiology of signs associated with a tonic pupil. Normally, all parasympathetic fibers of the third cranial nerve synapse in the ciliary ganglion (top). Most postganglionic fibers innervate the ciliary muscle (dashed lines). After injury to the ciliary ganglion, the pupil becomes denervated and larger (bottom). Denervation supersensitivity of the iris sphincter develops (depicted as an increase in the number of oval-shaped receptors). Some fibers never reinnervate the pupil (depicted as open circle neurons within the ciliary ganglion), whereas others reinnervate segments of the iris sphincter they had not innervated before injury. This haphazard process of denervation and reinnervation results in a poorly reactive pupil with segmental palsies of the iris sphincter. A greater proportion of postganglionic fibers that originally innervated the ciliary muscle become miswired and aberrantly reinnervate the iris sphincter muscle, resulting in more efficient pupillary constriction during accommodation than in response to light (i.e., light-near dissociation).
Date 2002
References Thompson HS: Segmental palsy of the iris sphincter in Adie's syndrome. Arch Ophthalmol 1978;96:1615-1620: http://www.ncbi.nlm.nih.gov/pubmed/687203
Language eng
Format image/jpeg
Type Image
Relation is Part of The Pupil: Neurology of the Iris
Collection Neuro-Ophthalmology Virtual Education Library: Moran Eye Center Collection: https://novel.utah.edu/Moran/
Publisher North American Neuro-Ophthalmology Society
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management Copyright 1986. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s61001jd
Setname ehsl_novel_jmec
ID 180388
Reference URL https://collections.lib.utah.edu/ark:/87278/s61001jd
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