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March 1986

Adie's Tonic Pupil in a Patient With Carcinomatous Neuromyopathy

Author Affiliations

Oxford, England

Arch Ophthalmol. 1986;104(3):331-332. doi:10.1001/archopht.1986.01050150025004

To the Editor.  —We describe a patient in whom Adie's tonic pupil developed during an exacerbation of chronic relapsing polyneuropathy. The subsequent development of metastases suggested that the polyneuropathy and tonic pupil were attributable to the presence of a carcinoma. The association of polyneuropathy and tonic pupils is recognized, but the association of tonic pupils and carcinomatous neuromyopathy has, to our knowledge, been previously reported only once. It is possible that this association occurs more commonly than is recognized.

Report of a Case.  —The patient, a 51-year-old man, had suffered relapsing polyneuropathy for four years. During this period, repeated admissions into the hospital were required where he received treatment with prednisolone. A further relapse rendered him unable to stand unaided and unable to walk. In addition, he developed a dilated left pupil.On examination, he was markedly wasted, and power in the limbs was reduced to Medical Research Council grade

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