Adie Syndrome

Brain & Nerve
Eye & Vision
Contributed byMaulik P. Purohit MD MPHMar 21, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Adie’s Tonic Pupil
  • Tonic Pupil Syndrome
  • Weill-Reys-Adie Syndrome

What is Adie Syndrome? (Definition/Background Information)

  • Adie Syndrome is a rare, neurological condition characterized by dilated pupils that react slowly to external stimuli such as light. While vision and reactivity of the eyes is lowered in those with Adie Syndrome, it is not a progressive or life-threatening condition
  • Occasionally, individuals with the condition may have one pupil that is constricted and smaller than the other pupil
  • The condition generally affects young women in the 20-40 age groups. Currently, the exact cause of Adie syndrome has not been identified and it cannot be prevented
  • Adie Syndrome presents with dilated pupil that react slowly to light, increased sensitivity to light, difficulty reading, and increased sweating. There are no disabling complications associated with this disorder
  • Treatments include wearing eye glasses to correct vision-related defects and the use of prescription eye drops. With appropriate treatment, the prognosis of Adie Syndrome is good

Who gets Adie Syndrome? (Age and Sex Distribution)

  • Women between the ages of 20 and 40 years are most susceptible to Adie Syndrome. This condition has also been observed in men
  • The female to male ratio is 5:2
  • In many of the cases, Adie Syndrome is genetically inherited

What are the Risk Factors for Adie Syndrome? (Predisposing Factors)

Common risk factors for Adie syndrome include:

  • Family history
  • Inflammatory or autoimmune disorders
  • Viral infections
  • Stress
  • Trauma
  • Eye surgery
  • Other eye complications

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Adie Syndrome? (Etiology)

Currently, the exact cause of Adie Syndrome is unknown. Medical experts believe that the following factors may contribute to Adie Syndrome:

  • Neurosyphillis: It is a sexually-transmitted disease affecting the brain in its later stages
  • Retinal detachment surgery
  • Diabetes
  • Giant cell arteritis (an inflammatory disorder of the blood vessels)

What are the Signs and Symptoms of Adie Syndrome?

Common signs and symptoms of Adie Syndrome include:

  • Slow pupillary reaction to stimuli such as light
  • Dilated pupils (but in some individuals it may be constricted)
  • Difficulty reading
  • Increased sensitivity to light
  • Lack of reflexes (in the tendon, ankle, and knee)
  • Excessive sweating

How is Adie Syndrome Diagnosed?

The diagnosis of Adie Syndrome may involve:

  • Evaluation of complete medical history
  • A general eye examination
  • Eye pressure measurement (tonometry)
  • Retinal examination
  • Slit lamp examination of the eye
  • Visual acuity using a Snellen and Jaeger chart
  • CT scan and MRI of brain to exclude other brain disorders

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Adie Syndrome?

  • There are no life-threatening or disabling complications associated with Adie Syndrome
  • Blurred vision and ocular pain are common in the eye that is affected

How is Adie Syndrome Treated?

The treatment of Adie Syndrome may include:

  • Eyeglasses to correct vision
  • Medications and prescription eye drops (pilocarpine) to constrict the pupils
  • In some cases, however, a thoracic sympathectomy or laser iridotomy may be performed

How can Adie Syndrome be Prevented?

  • Currently, there are no specific methods or guidelines to prevent Adie Syndrome, since it is a genetic condition
  • Genetic counseling will help assess risks, before planning for a child
  • Active research is currently being performed to explore the possibilities for treatment and prevention of inherited and acquired genetic disorders

What is the Prognosis of Adie Syndrome? (Outcomes/Resolutions)

  • The prognosis of Adie Syndrome is good with treatment, since it is not a progressive disorder
  • The affected individuals are able to lead a normal life with appropriate treatment

Additional and Relevant Useful Information for Adie Syndrome:

The following DoveMed website links are useful resources for additional information:

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Maulik P. Purohit MD MPH picture
Approved by

Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team


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