title: [Atypical tonic pupil as a complication of chickenpox infection].
abstract: BACKGROUND
  Pupillary disorders following varicella infections are rare and few cases have been reported which were only partially pharmacologically tested.
  
  
  METHODS
  A 5-year-old boy presented with a left-sided dilated and unreactive pupil, 3 months before he had suffered from chickenpox and in the course of the acute disease developed anterior uveitis which was treated with local prednisone and mydriatics. The pupil remained dilated despite discontinued medication, light reaction was absent and accommodation was impaired. Pilocarpine supersensitivity was an indication against a lesion of the sphincter muscle and reduced response to cholinesterase inhibitors (physostigmine) pointed towards a postganglionic lesion.
  
  
  CONCLUSIONS
  It is probable that a varicella virus infection of the short ciliary nerves and the ciliary ganglion caused anterior uveitis and a postganglionic parasympathetic nerve lesion, clinically presenting as a tonic pupil. According to cases previously reported an irreversible nerve lesion has to be assumed.
authors.affiliation: Universitäts-Augenklinik Heidelberg. theresheger@hotmail.com
authors.forename: T
authors.initials: T
authors.lastname: Heger
authors.forename: G H
authors.initials: GH
authors.lastname: Kolling
authors.forename: S
authors.initials: S
authors.lastname: Dithmar
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002644:Chickenpox / Q000150:complications*; D002675:Child, Preschool; D006801:Humans; D008297:Male; D008916:Miotics; D009184:Mydriatics / Q000627:therapeutic use; D010862:Pilocarpine; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D011379:Prognosis; D015845:Tonic Pupil / Q000175:diagnosis / Q000209:etiology*; D014606:Uveitis, Anterior / Q000188:drug therapy / Q000209:etiology*
chemical_list: D000893:Anti-Inflammatory Agents; D008916:Miotics; D009184:Mydriatics; D010862:Pilocarpine; D011241:Prednisone