Holmes-Adie pupil is a benign condition most commonly seen in women. It is one of the differentials of a dilated pupil.

Overview

• unilateral in 80% of cases
• dilated pupil
• once the pupil has constricted it remains small for an abnormally long time
• slowly reactive to accommodation but very poorly (if at all) to light

Holmes-Adie syndrome

• association of Holmes-Adie pupil with absent ankle/knee reflexes