The lesion can also lead to an atrophied or weakened iris. There are several diseases that can cause Argyll Robertson pupil, the most common of which are discussed below. Other potential causes are chronic alcoholism, shingles, Lyme disease, encephalitis and neurosarcoidosis. The most common cause of AR pupil is late-stage syphilis. Syphilis is a bacterial infection that causes lesions throughout the body. It is most commonly transferred through sexual intercourse. When left untreated, syphilis can progress through three stages. ![]() The final stage, also called tertiary syphilis, can lead to the development of Argyll Robertson pupil. Only one-third of individuals with syphilis will develop tertiary syphilis. During this stage, syphilis is not contagious.Ĭases of Argyll Robertson pupil that are not related to syphilis are also called pseudo-Argyll Robertson pupil. READ MORE: Ocular syphilis: Symptoms and treatment when syphilis spreads to the eyes Diabetes mellitusĭiabetes mellitus is a condition in which the body does not effectively regulate glucose levels in the bloodstream. Glucose is a sugar and the body’s main source of energy. READ MORE: How diabetes can impact the eyes Multiple sclerosis AR pupil can develop when long periods of high blood sugar levels cause nerve damage that triggers lesions. Multiple sclerosis (MS) is a disease that causes the body’s immune system to attack its central nervous system. The attacks target myelin, the protective layer surrounding nerve endings, creating lesions.īecause MS can attack any part of the nervous system, symptoms will vary from person to person. READ MORE: How multiple sclerosis impacts eyes and vision How is Argyll Robertson pupil diagnosed? If the lesions form in the area of the brain that controls the eye’s response to light, they can cause AR pupil. ![]() Healthy pupils expand (dilate) in dim light or when focusing on a distant object. They shrink (constrict) in bright light or when focusing on a nearby object. The first sign of Argyll Robertson pupil is slow constriction in bright light. If the pupil is still able to constrict quickly to focus on nearby objects, the eye doctor will then look for small, misshapen pupils. They may also perform a slit-lamp exam to check for a weakened iris. This exam involves the use of a microscope with a bright light that allows the physician to see inside the eye. ![]() If they suspect AR pupil, the eye doctor may refer the patient to an infectious disease specialist. The specialist will look for indications of tertiary syphilis. Tabes dorsalis, a form of neurosyphilis, is often present at this stage.
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