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 a 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. BE anterior segment, Extraocular movements normal. Deep tendon reflexes, BP,other systemic examination normal.colour vision, fields normal. Diluted 0.125%pilocarpine test done in dim light ,Pupillary light reflex recorded at baseline and 30min after the 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 negative. MRI brain normal.Based on above findings, a clinical diagnosis of exclusion Bilateral Adies pupil made. Best glasses for near vision prescribed .This case study presented for diagnostic challenge, rarity as 80% cases unilateral and rare incidence in young male.

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