Pathophysiology of signs associated with a tonic pupil

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Identifier Figure-16
Title Pathophysiology of signs associated with a tonic pupil
Subject Adie's tonic pupil; Pupil Disorders; Iris/physiopathology; 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).
Creator Daniel M. Jacobson, MD (1956-2003)
References Thompson HS: Segmental palsy of the iris sphincter in Adie's syndrome. Arch Ophthalmol 1978;96:1615-1620:
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Type Image/StillImage
Format image/jpeg
Relation is Part of The Pupil: Neurology of the Iris
Rights Management Copyright 2002. For further information regarding the rights to this collection, please visit:
Collection Neuro-ophthalmology Virtual Education Library: NOVEL
Language eng
ARK ark:/87278/s61001jd
Setname ehsl_novel_jmec
Date Created 2011-04-19
Date Modified 2012-10-22
ID 180388
Reference URL
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