Arrow pupil

Introduction The reflected light reflection disappears and the adjustment reflection exists. For the lesion in the anterior region of the apex, the light reflex path is damaged. The classic disease is due to neurosyphilis such as spinal cord spasm. At present, other lesions in the Edinger-Wesrphal nuclear region such as multiple sclerosis are more common.

Cause

Aropilin is a neurosyphilis such as the spinal cord. Currently, other lesions in the Edinger-Wesrphal nuclear region such as multiple sclerosis are more common.

Argyll Robertson's syndrome is also known as Aro's pupil, reflex iris palsy. In 1869, it was first reported by British eye scientist Douglas Argyll Robertson.

Aro is a unique sign of neurosyphilis. The light-reflecting path is caused by the destruction of syphilitic lesions (especially spinal cord hernia). The pupil dilation is associated with lesions in the vicinity of the interneurons in front of the cerebral nucleus.

an examination

Fundus examination: should be carried out in a dark room. The patient takes a seat and the doctor can take a seat or stand. The right hand held ophthalmoscope is located on the right side of the patient.

1 The retina is sensitive to light, no blindness, ie no abnormalities in the retina and optic nerve;

2 the pupil is reduced (within 3mm);

3 pupils disappear from light reflection;

4 convergence, normal adjustment of reflex;

5 physostigmine eye drops can cause contraction, while atropine eye drops are not complete;

6 pupil morphology abnormalities (irregular and marginal irregularities) and asymmetry;

7 These obstacles are permanent, mostly bilateral, and occasionally one side.

Differential diagnosis

In addition to neurosyphilis, Aroop is also found in other diseases, called pseudo-Argyll Robertson's syndrome. The manifestation is that the affected pupil is enlarged (80% is unilateral), the photoreaction disappears or is slow, and the convergence reaction is lightly affected. Occasionally, the affected pupil can be smaller than the normal pupil after slow contraction. Common causes include trauma to the midbrain; trauma to the eyeball or eye socket; tumors in the midbrain, such as the quadrilateral, pineal gland, third ventricle, and aqueduct; cerebrovascular disease (middle brain) Softening the skin) and multiple sclerosis. In this case, in addition to Aro's pupil, it is often accompanied by vertical gaze paralysis and other extraocular muscle paralysis.

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