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Argyll Robertson Pupil

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Argyll Robertson Pupil

(A) Baseline examination shows a miotic pupil. (B) There is no pupillary constriction in response to direct light stimulation. (C) Pupillary constriction occurs during accommodation to a near target, demonstrating preserved near response despite absent light reflex[1]
Findings of Argyll Robertson Pupils on Pupillary Reflex Exam. On pupillary exam, Argyll Robertson pupils do not react to light but show prompt constriction with near accommodation[2]
  • Argyll-Robertson pupil
  • Robertson pupil
  • Argyll Robertson phenomenon
  • Neurosyphilitic pupil
  • Light-near dissociation pupil

Purpose

  • Clinical sign used to assess pupillary function
  • Helps identify disorders affecting the pupillary light reflex pathwa
  • May provide an important clue to underlying neurologic disease
  • Classically associated with neurosyphilis
  • First described by Douglas Argyll Robertson in 1869[3]

Description

  • Small, often irregular pupils
  • Poor or absent constriction in response to light
  • Preserved constriction during accommodation and convergence
  • Classic example of light-near dissociation
  • Usually bilateral but may be asymmetric

Pathology

  • Neurosyphilis (classic)
  • Tabes Dorsalis
  • Diabetic autonomic neuropathy
  • Multiple sclerosis
  • Midbrain lesions
  • Encephalitis

Evidence

  • Unknown

See Also

References

  1. ↑ Penney, Dawn C., Zoë M. Rushetsky, and Donald W. Penney. "Abnormal pupils at the bedside: rapid recognition of neurologic and systemic emergencies in acute care settings." International Journal of Emergency Medicine 19.1 (2026): 73.
  2. ↑ Dichter, Sarah L., Mahammed Z. Khan Suheb, and Greggory S. Shubert. "Argyll Robertson Pupil." StatPearls [Internet]. StatPearls Publishing, 2024.
  3. ↑ Robertson, Douglas Argyll. "Four Cases of Spinal Myosis; with Remarks on the Action of Light on the Pupil." Edinburgh Medical Journal, vol. 15, no. 6, Dec. 1869, pp. 487–493
Created by:
John Kiel on 5 June 2026 20:31:41
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Last edited:
9 June 2026 23:10:09
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