Conveniently, a popular mnemonic to remember Argyll Robertson pupils is that, just like prostitutes, they "accommodate but do not react". Named after Douglas Argyll Robertson (1837–1909), a Scottish surgeon and ophthalmologist, who first described this condition in mid-1860s in patients with neurosyphilis.Īrgyll Robertson pupils are also sometimes called "prostitute's pupils" because of their association with late neurosyphilis. The exact anatomical lesion behind this phenomenon is unknown but is thought to be caused by bilateral damage of the pretectal nuclei in the midbrain. When seen in these non-syphilitic etiologies, the pupil is termed ' pseudo-Argyll Robertson pupil' 3. Argyll-Robertson pupil is one of the most common presenting signs in tabes dorsalis but our patient did not display this manifestation. To confirm diagnosis of Horners syndrome: Cocaine 4. Adie has gone so far as to say, 'The true Argyll-Robertson sign is an infallible sign of syphilis.' The Argyll-Robertson pupil, as described by its. Differential Diagnosis of small pupil: Argyll-Robertson pupil (syphilis), opiates, pilocarpine drops. It is a highly specific sign of late neurosyphilis, however can also occur in diabetic neuropathy, multiple sclerosis, alcoholic midbrain degeneration, and stroke 2,3. This is not good practice because (1) the pupil does not correspond to the postulates of Argyll-Robertson and (2) the use of such terms implies that the patient has syphilis. Argyll Robertson pupil is usually bilateral and presents as bilaterally miotic and irregular pupils, which constrict briskly with accommodation but do not react to bright light therefore displaying light-near dissociation 1.
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