Atrophy and depigmentation are also reported as rare causes. If it occurs secondary to syphilis, then pupil generally appears to be unequal and irregular. This area involves pupillary fibers which are responsible for reflecting light. Scientist believe that roastal midbrain present in vicinity of cerebral aqueduct of third ventricle is the main area of damage regarding Argyll Robertson pupil. The Argyll Robertson pupil results in lesion to the pretectal nuclei in the mid brain. The main mechanism or etiology is still unclear but it can occurs secondary to many diseases like syphilis. It is similar to near sightedness in which far vision is blurred and near vision is accurate. Vision is effected and patient is not able to see distinct objects but can see nearly placed objects. Other symptoms reported are iris atrophies along with loss in its radial folds. The abnormal functioning of pupil starts with a very sluggish response to direct light and this abnormal response to direct light leads it towards complete loss of reflection to light. Some scientist believe that the rostal midbrain in the vicinity of the sylvian aqueduct of the 3rd ventricle is area of damage.Īrgyll Robertson pupil shows consistent pupillary findings with the passage of time from months to years. Pathophysiology behind Argyll Robertson pupil is not clear yet.

This condition was 1st described by a scientist named Douglas Argyll and named this disease after his own name. As miotic pupil occurs due to lesion in dorsally placed fibers which are responsible for light response. The pupil better respond to accommodation as compare to stimulus of light. The diagnostic test of Argyll Robertson pupil does not require any special equipment and can be diagnosed easily. It is considered a neurological disorder biomarker like in neurosyphilis, neuro sarcoidosis and multiple sclerosis. This reaction of pupil is a way to confirm the functionality of the optic nerve pathway. Its been more than a century, this condition is describing. Argyll Robertson pupil is a miotic pupil which cannot reflect to direct light but efforts towards accommodate light. It is a symptom of tabetic neurosyphilis. There is a loss of pupillary reflex to direct light and have normal constriction of pupil while seeing near objects. Argyll Robertson is also credited with being the first to recommend trephining the sclera in those cases of glaucoma where extensive degenerative changes in the iris made an iridectomy impracticable.Ĭonclusion As we approach the centenary of his death Argyll Robertson deserves to be celebrated for more than his pupil.Argyll Robertson pupil is a type of reflex iridoplegia along with miosis and irregular shape. His other contributions include: lupus of the eyelid, aetiology of glaucoma, melanotic tumor, diphtheritic ophthalmia, sympathetic ophthalmia, retinitis pigmentosa, hypertrophy of the lacrimal gland, senile entropion, hydrophthalmos, asteroid hyalitis, pulsating exophthalmos, conjunctival filiariasis, albuminuric retinitis, miner’s nystagmus and microphthalmos. This condition was named the 'Argyll Robertson pupil' and as a clinical sign is almost always indicative of neurosyphilis. He also described in cases of spinal cord disease that there may be loss of the light reflex of the pupil but retention of its movement in accommodation. He introduced extracts of Calabar bean (Physostigma venenosum), in the treatment of glaucoma. Argyll Robertson made major contributions to ophthalmic surgery. Douglas completed his medical education under von Arlt in Prague and Albrecht von Graefe in Berlin. In this he was no doubt encouraged by the memory of his father, John Argyll Robertson, who was one of the founders of the Edinburgh Eye Dipensary but who had died when his son was only 18 years of age. Results Douglas Argyll Robertson (1837-1909) was the first surgeon in Scotland to practice entirely in the field of ophthalmology.

Methods The data dealt with in this paper is analysed both from the historical and present-day perspectives. Purpose To study medical achievements of Douglas Argyll Robertson in ophthalmology.

Argyll robertson pupil