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Ophthalmology Neuro-Ophthalmology c5aa7b75

In Holmes-Adie pupil all are true except-

A
There is absent or retarded pupil reaction to light and near
B
Most cases are bilateral
C
Causes reduced or absent accommodation
D
Constricts with 2.5% methacholine
High-Yield Explanation
Ans. (b) Most cases are bilateralRef: Kanski 7/e, p. 815Typically affects young adults and presents as unilateral condition in 80% casesDLR and CLR are absentNear reflex is blow (sluggish)As there is defect in post-ganglionic para-sympathetic innervation to eye, i.e., there is deficiency of parasympatholytic system, the pupil will react when even a minimum concentration of parasympathomimetic drugs (e.g. 0.125% pilocarpine, 2.5% methcholine) is given.

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