In Holmes-Adie pupil all are true except-
Ans. (b) Most cases are bilateralRef: Kanski 7/e, p. 815Typically affects young adults and presents as unilateral condition in 80% casesDLR and CLR are absentNear reflex is blow (sluggish)As there is defect in post-ganglionic para-sympathetic innervation to eye, i.e., there is deficiency of parasympatholytic system, the pupil will react when even a minimum concentration of parasympathomimetic drugs (e.g. 0.125% pilocarpine, 2.5% methcholine) is given.
There is absent or retarded pupil reaction to light and near
Most cases are bilateral
Causes reduced or absent accommodation
Constricts with 2.5% methacholine
Neuro-Ophthalmology