Robertson reasoned that a lesion in the ciliospinal sympathetic nerves was responsible for the syndrome. Argyll robertson pupil jama neurology jama network. Argyllrobertson pupil definition of argyllrobertson. Argyll robertson pupil small 1 mm to 2 mm irregular in outline light near dissociation react poorly or not at all to light, but very well to near anterior visual pathway function must be normal generally bilateral and symmetric lesion lies in the periaqueductal region, pretectal area and rostral midbrain dorsal to the. In 1869 douglas moray cooper lamb argyll robertson described his famous pupillary sign in two papers.
Robertson noted the association between the pupillary syndrome and disease of the spinal cord. Ogilvie departments of ophthalmology and pathology, permanente medical group. He was born at 58 queen street in edinburgh in 1837, the son of dr john argyll robertson, a surgeon with an interest in surgery of the eye who had served as president of the royal college of surgeons of edinburgh in 1846. Abstract a case in which argyll robertson pupils developed in the course of a toxic polyneuritis and disappeared with the subsidence of the disease should be recorded for two reasons. Argyllrobertson pupil key points in 60 seconds youtube. Argyll robertson pupil definition of argyll robertson pupil.
Argyll robertson pupil one that is miotic and responds to accommodation effort, but not to light. Mar 14, 2017 argyll robertson pupil small 1 mm to 2 mm irregular in outline light near dissociation react poorly or not at all to light, but very well to near anterior visual pathway function must be normal generally bilateral and symmetric lesion lies in the periaqueductal region, pretectal area and rostral midbrain dorsal to the. The constellation includes argyll robertson pupil, ataxic widebased gait, bowel or bladder incontinence, loss of position and vibratory sense, loss of deep pain and temperature sensation, acute episodic gastrointestinal pain, charcot joints, general paresis. Argyll robertson pupils ar pupils are bilateral small pupils that constrict when the patient focuses on a near object they accommodate with near vision, but do not constrict when exposed to bright light they do not react to light. Argyll robertson pupil plural argyll robertson pupils pathology a bilateral small pupil of the eye that reduces in size when the patient focuses on a near object but does not constrict when exposed to bright light. Argyll robertson pupil definition of argyll robertson. The significance of the unilateral argyll robertson pupil. 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 lightnear dissociation 1. The dimensions of the pupil change according to the amount of light present. Included in this was operation mincemeat the disinformation campaign was successful in persuading the germans.
Argyll robertson pupil in one eye refers to a condition in which the pupil of one eye constricts when a person focuses on a near object but does not constrict normally when exposed to bright light. Here are links to possibly useful sources of information about argyll robertson pupil. Argyll robertson pupil radiology reference article. Pdf inverse argyll robertson pupil in burkitts lymphoma. Pupil testing and responses argyll robertson pupil youtube. A form of reflex iridoplegia characterized by miosis, irregular shape, and a loss of the direct and consensual pupillary reflex to light, with normal pupillary constriction to a near vision effort lightnear dissociation. Argyll robertson pupil the argyll robertson pupil are known to be bilateral small sized pupils which can get constricted when a person forcefully tries to discern nearby objects. Argyll robertson pupil medical definition merriamwebster. Like his two older brothers robert and william, he studied medicine at edinburgh university medical. Started in 1995, this collection now contains 6769 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. Argyll robertson pupils in alcoholism archives of neurology. Argyll robertson pupils ar pupils or colloquially as prostitutes pupil are bilateral small pupils that reduce in size when the patient focuses. More recently, descriptions of socalled argyll robertson pupils in other diseases have appeared. Synonyms for argyll robertson pupil in free thesaurus.
However, we have not seen typical argyll robertson pupils narrow pupils unreactive to light but reactive to near vision with positive. For many years the curious pupillary phenomena first described by argyll robertson in 1869, and which have since borne his name, were regarded as pathognomonic of syphilis of the central nervous system. It has been reported in patients with diabetes mellitus, multiple sclerosis, wernickes encephalopathy, sarcoidosis, tumours, and haemorrhage. Argyll robertson pupil refers to a disorder whereby the pupil does not change size in response to light. However, they do not do the same in bright light condition and thus the ailment is really something different and disturbing. Lockhart robertson was an eminent psychiatrist and lord chancellors medical visitor. In the early 20th century, william john adie described a second type of pupil that could accommodate but not react. Moore 11 stated that in cases of nonsyphilitic conditions the pupil has special characteristics. Argyll robertson pupils ar pupils or colloquially as prostitutes pupil are bilateral small pupils that reduce in size when the patient focuses on a near object they accommodate. Argyll robertson pupils medigoo health medical tests. Argyll robertson was also the first to demonstrate the cholinergic ocular effects of an extract from the calabar bean, the drug physostigmine. He was apprenticed to john henry wishart, a surgeon with an interest in eye conditions at edinburgh royal infirmary. Most descriptions of the ar pupil do not mention segmental iris sphincter constriction, or slow, sustained constriction with a near vision effort.
Argyll robertson pupil ophthalmology mcq pg blazer. Argyllrobertson pupil definition of argyllrobertson pupil. Argyll robertson pupil an overview sciencedirect topics. Most descriptions of the ar pupil do not mention segmental iris sphincter constriction, or slow, sustained constriction with a near vision.
Gummatous disease may present with destructive inflammation and spaceoccupying. Anatomical basis of argyll robertson pupil prostitutes pupil. The argyll robertson pupil, a miotic pupil that responds to an. Apr 07, 20 it is a sign of several distinct disorders of the central nervous system, such as brain tumor, multiple sclerosis, and neurosyphilis. 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 lightnear dissociation 1 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. Helmut wilhelm, in handbook of clinical neurology, 2011. By pranab chatterjee on june 29, 2011 3 comments argyll robertson pupils ar pupils are bilateral small pupils that constrict when the patient focuses on a near object they accommodate, but do not constrict when exposed to bright light they do not react to light. A pseudo argyll robertson pupil is a neurological sign indicating a normal near reflex but the absence of a light reflex lightnear dissociation, a lack of miosis, and pupil irregularity. The argyll robertson ar pupil has been defined as a pupil that is small and constricts poorly to direct light but briskly when a target within reading distance is viewed lightnear dissociation. Thomas argyll robertson obe 27 october 1909 10 may 1994, known as tommy or by his initials as tar, was a scottish mi5 intelligence officer responsible during the second world war for the doublecross xx disinformation campaign against the german intelligence services. Argyll robertson pupil an ocular finding, now of largely historic interest, for a pupil that can focus on a near object accommodate but does not react to light, which is classically described in tertiary syphilis. The definition should be strict otherwise a whole host of pupillary abnormalities with some degree of lightnear dissociation will be so designated. Ogilvie departments of ophthalmology and pathology, permanente medical group, kaiser foundation hospital, oakland, california, u. Suele ser bilateral, pero asimetrica, siendo las pupilas pequenas.
The pathophysiologic mechanism which produces an argyll robertson pupil is unclear. Inverse argyll robertson pupil, argyll robertson pupil, pupillary abnormalities, burkitts lymphoma argyll robertson pupil syndrome is characterized by absence of pupillary light reflex with retention of pupillary constriction to near vision thompson 1987. Argyll robertson pupil argyll robertson described his pupillary syndrome in 1869. Douglas moray cooper lamb argyll robertson 18371909 was a scottish ophthalmologist. Argyll robertson 10 described the characteristic pupil as miotic, not responding to light but reacting normally to stimuli of accommodation and convergence, and of irregular outline, with little or no response to mydriatic drugs or psychogenic stimuli. I could not observe any contraction of either pupil under the influence of light, but, on accommodating the eyes for a near object, both pupils contracted. The two different types of near response are caused by different underlying disease processes. Douglas argyll robertson 18371909, british ophthalmologist argyll robertson pupil. However, we have not seen typical argyll robertson pupils narrow pupils unreactive to light but reactive to near vision with positive serological. Example of patient with argyll robertson pupil with neurosyphilis. Argyll robertson pupil is ascribed to a lesion of intercalated neurons in the midbrain or to damage of inhibitory fibers to the oculomotor nucleus loewenfeld, 1969. Argyll robertson pupil synonyms, argyll robertson pupil.
Argyll robertson pupil article about argyll robertson pupil. Studies have failed to demonstrate a focal localising lesion. Shows a lack of pupillary response to light and some pupillary response to. Argyll robertson pupil arp it is characterised by bilateral constricted pupils. Ideal sources for wikipedia s health content are defined in the guideline wikipedia. Jul 04, 2017 argyll robertson pupils ar pupils or, colloquially, prostitutes pupils are bilateral small pupils that reduce in size on a near object i. Argyll robertson pupil arp, also called ar pupils, refers to small bilateral pupils that constrict when a person tries to focus on a near object but do not constrict when the eyes are exposed to light of bright intensity 1. Pupils and prostitutes litfl ophthalmology befuddler. Inverse argyll robertson pupil in burkitts lymphoma. Inverse argyll robertson pupil in burkitts lymphoma article pdf available in clinical ophthalmology auckland, n. Later, the argyll robertson pupil was found usually to be the result of neurosyphilis, and it became a cardinal sign of the disease. Argyll robertson pupil synonyms, argyll robertson pupil pronunciation, argyll robertson pupil translation, english dictionary definition of argyll robertson pupil. The term argyll robertson pupils was named after douglas argyll robertson 18371909, a scottish ophthalmologist and surgeon, who described the condition in the mid 1860s in the context of neurosyphilis. Argyll robertson pupils ar pupils or, colloquially, prostitutes pupils are bilateral small pupils that reduce in size on a near object i.
241 535 729 394 638 150 626 906 1484 562 595 532 168 441 1124 1037 1482 585 796 532 1455 1001 287 1026 282 785 521 453 1041 438 264 1446 1490 5 1474 856 837 686 121