Holmes-Adie's Syndrome

The Holmes-Adie's syndromes is a benign but curious Idiopathic disorder Involving the pupils and tendon reflexes. It Is known by a variety of names Including puplllotonlc pseudotabes, non-leutlc Argyll Robertson pupils, partial lrldioplegiaand Markus-Weill syndrome. Typically, the pupil Is large and becomes smaller wtth Increasing age. The affected pupil reacts poorly, if at all, to light. With accommodation, It contracts tonically and redliates as slowly with distant fixation. It is more common in women than men (4:1). Usually unilateral at presentation (80-90%), there Is a tendency for the fellow pupil to become Involved over time. Tendon reflexes are depressed in the majortty of patients (75-90%).