The Pupil is an organ in the eye that controls the amount of light that reaches the retina. Pupils vary in size and shape in humans, and as many as 20% of all species have an irregular-shaped pupil. Not all pupils are round, however, and some have slit-shaped openings. If you notice an unusual pupil, you may have syphilis or argyll Robertson’s sign.
Argyll Robertson pupil
The Argyll Robertson pupil is an abnormal pupil that does not constrict when bright light is shined into it. This is often associated with neurosyphilis, and was once thought to be indicative of a disease called SYPHILIS affecting the nervous system. Until recently, this condition was thought to be an indicator of syphilis, but recent research has found that the pupil can be a symptom of other diseases as well. Until recently, Argyll Robertson pupil was a symptom of syphilis, but it has been reported in other neurological diseases and even in multiple sclerosis. In this article, the authors report cases of multiple sclerosis in patients who have the Argyll Robertson pupil, concluding that this condition is much more common than previously thought.
Currently, the treatment of Argyll Robertson pupil depends on the underlying cause. In cases of tertiary syphilis, penicillin G may be administered intravenously or intramuscularly, and probenecid may be used to increase the amount of penicillin in the bloodstream. Antiseizure drugs and antidepressants may also be used to treat nerve damage caused by diabetes. Likewise, steroids and glatiramer acetate may be used to treat multiple sclerosis.
Marcus Gunn pupil
The primary way to diagnose Marcus Gunn pupil is to use a swinging light test. During this test, your doctor will swing a light in front of your pupils and compare how your pupils react to the stimulus. The direct response occurs when light is shone into one eye, while the consensual response occurs when light is shone into the other. A physician may recommend a surgical procedure to address the underlying cause.
The swinging-flashlight test is used to elicit the Marcus Gunn sign. The swinging light test reveals a condition wherein the pupil in one eye does not dilate when light is shined into the other. A patient with this condition does not dilate while light shines into the other eye, but instead, paradoxically dilates as the light moves quickly over the affected eye. This is caused by a lack of afferent fibers delivering sensory information from the cranial nerve III.
Argyll Robertson sign
The Argyll Robertson sign for pupil occurs in patients with late-stage syphilis, a condition caused by the spirochete Treponema pallidum. Its underlying cause is syphilis, and treatment for AR pupils depends on the underlying disease. In case of tertiary syphilis, penicillin G is given intravenously or intramuscularly. Other treatment options include probenecid, which increases the level of penicillin in the body. Treatment for multiple sclerosis may also include steroids or glatiramer acetate.
The Argyll Robertson sign for pupil refers to the condition of pupils with small, irregularly shaped pupils. These pupils often do not constrict when exposed to bright light. Usually, these patients suffer from tertiary syphilis, but the condition may also occur in people with diabetes or multiple sclerosis. In most cases, the disease is treatable with a combination of probenecid and penicillin G.
Argyll Robertson pupil caused by syphilis
Argyll Robertson pupils are bilaterally small and do not constrict, even when exposed to bright light. Consequently, they are a highly specific symptom of late-stage syphilis. In this activity, you will learn how to correctly evaluate patients with Argyll Robertson pupils, summarize management and treatment options for the patient, and review the pathophysiology of Argyll Robertson pupils.
The first time an Argyll Robertson pupil was described, it was in the mid-1850s by Dr. Douglas Moray Cooper Lamb of the Edinburgh School of Medicine. It is caused by the bacteria Treponema pallidum and is usually transmitted by sex. The resulting damage to the pupillary light reflex pathway is known as tertiary syphilis.
Drugs that affect pupils
People may be able to determine if they are intoxicated by the size of their pupils by looking at them. A drug can dilate the pupils by altering the neurotransmitters in the brain, which control the reactions of light and other chemicals in the body. Drugs that affect pupils may include benzodiazepines, antihistamines, muscle relaxants, and antidepressants. Many prescription stimulants also cause the pupils to dilate.
If the cause is pharmacologic, the patient should be consulted. Symptoms of pharmacological dilation of the pupil are a poor response to light and near light. Depending on the agent and the route of administration, the patient may require follow-up visits. However, if the patient’s pupils remain dilated, further evaluation of the underlying causes is necessary. Here are the possible causes.