Walsh & Hoyt: Light-Near Dissociation

Normal pupils constrict not only from light stimulation but also during near viewing as part of the near response of convergence, accommodation, and miosis. Whenever the pupil light response appears sluggish, inextensive, or weak, the near response should be checked. Constriction of the pupils during near viewing that is stronger than the light response (lightnear dissociation) is an important clinical observation. Argyll Robertson pupils. Inverse argyll robertson pupils. Mesencephalic lesions. Lesions of the afferent pathway. Abberrant regeneration after damage to the innervation of the iris sphincter.