Argyll Robertson (AR) Pupil is defined as small Pupils and reflects poorly direct light however rapidly when an object present at the reading distance is viewed. Small irregular Pupils are said to be caused due to tertiary syphilis. They are irregularly shaped of almost 2mm size small and react poorly or sometimes do not react to the light. The response to adjustment and convergence remains integral.
Argyll Robertson (AR) Pupil is usually asymptomatic. Small irregular Pupils are found in the eye due to this disorder. Bilateral and asymmetric, light-near dissociation, miotic Pupils, poor pharmacologic dilation, iris atrophy are some of the features of the disorder. The dysfunction of the Pupil starts with one eye and can be joined by other eye with time. The abnormality in Pupillary function starts from the dull response to light and eventually advances across the period of months to years and leads to complete loss of the light reflex.
Light- near dissociation-The light-near dissociation (LND) is a generic term used to describe a diminished response to light which is not totally absent. Syphilis is recognized as the most popular cause of LND.
Syphilis is the major cause of Argyll Robertson Pupil and hence it should be treated in priority. Administration of penicillin intravenously is the method to treat almost all stages of syphilis. Doxycycline or tetracycline can be used as alternative medicine.
Syphilis is not the only cause of poorly reactive Pupils. Other disorders associated are:-
Argyll Robertson Pupil is one distinctive type of disorder associated mostly with syphilis. A tonic Pupil (of Adie) resembles the Argyll Robertson Pupil but is not seen to be associated with syphilis.