SOME CLINICAL phenomena may be viewed as experiments of nature and serve to stimulate investigation into the mechanisms of normal function. An example is Argyll Robertson's pupillary syndrome.
Douglas Argyll Robertson of Edinburgh was a pioneering ophthalmic surgeon who made several important contributions to our basic understanding of ocular mechanisms.1,2 In 1869, the same year that Johann Friedrich Horner described his well-known form of miosis,3 Robertson reported miosis of another type, characterized by absence of the pupillary light reflex with retention of pupillary contraction to near vision.4,5
Robertson noted the association between the pupillary syndrome and disease of the spinal cord. Later, the Argyll Robertson pupil was found usually to be the result of neurosyphilis, and it became a cardinal sign of the disease.6
Robertson reasoned that a lesion in the ciliospinal (sympathetic) nerves was responsible for the syndrome. The matter is still unsettled despite
Wilkins RH, Brody IA. Argyll Robertson Pupil. Arch Neurol. 1968;19(4):443. doi:10.1001/archneur.1968.00480040109012