This paper reports a patient with Adie's syndrome followed for 25 years. During this time no change occurred in the characteristic pupillary reaction to light or convergence, and the pupil remained sensitive to methacholine (Mecholyl). The original observation on sensitization to methacholine was made upon this patient by one of us,1 and peripheral denervation suggested as the mechanism. Weber2 has previously reported a patient with tonic pupil who had been followed for 27 years, but continued hypersensitivity to methacholine has not been reported.
Report of a Case
The patient, a white female now 53 years old, was originally seen in consultation to rule out possible central nervous system involvement with an infection in the right eye and pain radiating into the eye. The condition, however, proved to be otitis externa with tonic pupil an incidental finding. Her eyes were otherwise normal. The right pupil was smaller (4
LATIES AM, SCHEIE HG. Adie's Syndrome: Duration of Methacholine Sensitivity. Arch Ophthalmol. 1965;74(4):458-459. doi:10.1001/archopht.1965.00970040460004