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August 1971

Tonic Pupil Following Retinal Detachment Surgery

Author Affiliations

Bethesda, Md
From the Clinical Branch, National Eye Institute, National Institutes of Health, Bethesda, Md.

Arch Ophthalmol. 1971;86(2):233-234. doi:10.1001/archopht.1971.01000010235017

THE complete syndrome of tonic pupil consists of mydriasis, absent or inextensive light reflexes, extensive but slow constriction to accommodation, and a variable degree of impairment of accommodation. This pupillary abnormality most frequently has no known cause, but has often been reported following trauma to the eye or orbit.1 It is interesting that pupillotonia following retinal detachment surgery has been described only by Adler and Scheie,2,3 although it represents a potential complication when the inferior oblique muscle is removed or extensive scleral dissection or diathermy performed.

Report of a Case  A 55-year-old white man was seen in the outpatient clinic of the National Eye Institute on March 9, 1970, with the following history. His vision was apparently normal until September 1967, when it rapidly became blurred in both eyes. He was told by his physicians that he had Doyne's choroidal dystrophy bilaterally. The patient's past history and review

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