DR. SARANYA THIRUNTHAIYAN

DR.KALAISELVI BALASUBRAMANIAN, DR. LATHA K.S.T., DR. SHEELA SUBRAMAMAN

Abstract

A14 year male presented with complaints of photophobia,difficulty in reading for 1 year.No headache,fever,ocular trauma/surgery,systemic/autoimmune disorders.BE BCVA 6/6 Near vision N8+0.5DSN6. BE pupils 5 mm not reacting to direct and indirect light reflex.Accomodation reflex absent.Both eyes anterior segment findings ,Extraocular movements normal. Deep tendon reflexes,BP, systemic examination normal. colour vision, fields normal. Diluted 0.125%pilocarpine test in a dim light .Pupillary light reflex recorded at baseline and 30min after drops showed constriction of both pupils.BE predrug near vision N8, NPA-14cm, NPC-9cm ,post drug near vision N6,NPA-10cm,NPC-7cm. syphilis, viral markers were negative. MRI brain normal.Based on above findings, clinical diagnosis of exclusion Bilateral Adies pupil made. Best glasses for near vision prescribed .This case study is presented for diagnostic challenge and rarity as 80% cases unilateral and rare incidence in a young male.