Argyll Robertson Pupil
What’s going on?
The patient has a pupil abnormality classically related to neurosyphilis. The cerebral centres responsible for stimulating pupil constriction in response to a bright light and to looking at a near object (accommodation) are separate. Lesions that block the light reflex may spare the accommodation reflex. Such lesions result in an Argyll Robertson pupil.
If I examine the patient what will I find?
The pupils will not react to light, but when the patient is asked to read the pupils will miose (constrict). This is called light-near dissociation.
What if I’ve diagnosed it?
Refer soon via letter.
What will the hospital do?
Screen for leutic disease. Neuro-imaging may be indicated to exclude a space-occupying lesion.