<prompt> Adeis atonic pupil is due toLoss of sympathetic nerve supplyLoss of parasympathetic nerve supplyVascular ischaemiaInfective neuritis  <response>: B Loss of parasympathetic nerve supply 313- Khurana 5thADIES TONIC PUPIL - caused by post ganglionic parasympathetic pupillo motor damage Usually unilateral associated with absent knee jerk, common in young woman Reaction to light is absent and to near reflex is very slow and tonicComparison bwtween Argyll-Robertson pupil and Adies pupilFeaturesARPAdie pupilVisionGoodGoodPupilConstrictedDilated AnisocoriaLateralityBilateral, may be unilateralUnilateral, may become bilateralEffect of illuminationNilLarger in bright lightLight reflex Direct and consensualAbsentAbsent poorNear reflex AccomodationBriskTonicAtropineNo mydriasisMydriasisMioticConstrictConstrict with, very weak solutionLesionPretectalCiliary ganglionARP- first described in neuro-syphilis, but this may be seen in several conditions affecting the midbrain including Encephalitis, CVA, M.S etcHutchinsons pupil- developed after the head injury H tor HThere is widely dilated immobile pupil on the same side as the head injury. Both the direct and the concensual reflexes to light are lost 