Bilateral Tonic Pupils in the Absence of Pupillary Cholinergic Supersensitivity

Abstract

We report a 24-year-old woman with a presenting complaint of bilateral dilated pupils. The pupils were found to be dilated in bright and dim room lighting with minimal light reaction, showed an accommodation response, but did not demonstrate cholinergic supersensitivity. Neurological examination and neuro-imaging of the patient were normal. Syphilis serology was negative. This case emphasises that tonic pupil may be found in the absence of pupillary cholinergic supersensitivity.

KEYWORDS::

• cholinergic supersensitivity
• tonic pupil

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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