Bilateral tonic pupils associated with neurosyphilis.
BACKGROUND
To describe 4 patients with bilateral tonic pupils in neurosyphilis.


METHODS
Four young men had pupillary abnormalities, which involved irregular shapes, large sizes, tonic reactions, and vermiform movements of both pupils with light-near dissociation. Cholinergic supersensitivity defined bilateral tonic pupils.


METHODS
Neurosyphilis was diagnosed in these patients on the basis of ocular and laboratory findings.


CONCLUSIONS
Bilateral tonic pupils may be important as initial findings in neurosyphilis. We conclude that patients with bilateral tonic pupils should undergo serologic tests for syphilis.
Sakai
Tsutomu
T
Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan.
Shikishima
Keigo
K
Mizobuchi
Tokihide
T
Yoshida
Masaki
M
Kitahara
Kenji
K
D000328:Adult; D002555:Cerebrospinal Fluid / Q000166:cytology; D003937:Diagnosis, Differential; D016508:Fluorescent Treponemal Antibody-Absorption Test; D006801:Humans; D007964:Leukocytosis / Q000175:diagnosis; D008297:Male; D009494:Neurosyphilis / Q000150:complications* / Q000175:diagnosis; D015845:Tonic Pupil / Q000175:diagnosis / Q000209:etiology*