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Ophthalmology General 9598728c

Eye examination of a patient shows bilaterally small pupils, with normal reaction to near reflex, but absent light reflex. A diagnosis of Argyll Robeson pupil is made. Which of the following condition is associated with classical Argyll Robeson pupil?

A
Multiple sclerosis
B
Mid brain tumor
C
Neurosyphilis
D
All of the above
High-Yield Explanation
Presence of bilaterally small pupils with preserved near reflex and absent light reflex indicates Argyll Robeson pupil. Classical Argyll Robeson pupil is seen in Neurosyphillis. In this condition both pupils are miotic and they dilate poorly with mydriatics. It is caused by a lesion in the tectum of midbrain. Light near dissociation is present in advanced diabetes mellitus, tumors of pituitary gland, midbrain lesions (Perinaud's syndrome), myotonic dystrophy, Adie's tonic pupil, familial amyloidosis, and peripheral neuropathies associated with alcoholism. Ref: Postgraduate Ophthalmology, Volume 2 By Zia Chaudhari, page 1565

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