In Holmes-Adie pupil all are true except -
The Adie's tonic pupil. In this condition reaction to light is absent and to near reflex is very slow and tonic. The affected pupil is larger (anisocoria). Its exact cause is not known. It is usually unilateral, associated with absent knee jerk and occurs more often in young women. Adie's pupil constricts with weak pilocarpine (0.125%) drops, while normal pupil does not. Ref:AK Khurana 4thE pg 293
There is absent or retarded pupil reactions to light and near
Most cases are bilateral
Causes reduced or absent accommodation
Constricts with 2.5% methacholine
Neuro-ophthalmology