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Tonic pupil and sarcoidosis
Esther M Bowie1, Syndee J Givre
1Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA
American Journal of Ophthalmology
|March 5, 2003
Summary
Tonic pupil, a condition affecting pupillary response, can be linked to sarcoidosis. Magnetic resonance imaging (MRI) may reveal ciliary ganglion enhancement in these cases, aiding diagnosis.
Area of Science:
- Ophthalmology
- Neurology
- Rheumatology
Background:
- Sarcoidosis is a multisystem inflammatory disease.
- Tonic pupil is characterized by a delayed and sluggish pupillary light reflex.
Observation:
- A 52-year-old woman with known sarcoidosis presented with a right tonic pupil.
- The pupil showed sectoral palsy and light-near dissociation.
- Pilocarpine testing revealed pupillary sphincter supersensitivity.
Findings:
- Contrast-enhanced magnetic resonance imaging (MRI) demonstrated enhancement in the region of the right ciliary ganglion.
- This finding suggests neurosarcoidosis affecting the parasympathetic innervation of the pupil.
Implications:
- Tonic pupil can be an ocular manifestation of sarcoidosis.
- MRI findings of ciliary ganglion enhancement support this association.
- Sarcoidosis should be considered in the differential diagnosis of tonic pupil.