Atonic Pupil

Clinical Feature

• Symptoms: glare.
• Signs: enlarged, irregular, poorly reactive pupil.
• May occur following pupil stretching or sphincterotomies during cataract surgery for a small, non-dilated pupil.
• Commonly seen in patients on long-term miotic drops.

Management

• Treatment of symptoms to reduce glare with sunglasses, shades or tinted contact lens.
• Pilocarpine may be useful to regularize the pupillary border.