Holmes Adie Syndrome, diagnosis, treatment of Holmes Adie Syndrome

Holmes Adie Syndrome

  • Posted on- Oct 15, 2015
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Holmes-Adie Syndrome is a neurological disorder that affects the pupil of the eye and the autonomic nervous system. In Holmes-Adie Syndrome, the pupil of the affected eye is larger than the unaffected eye. The affected pupil constricts slowly when exposed to bright light. Patients with this disease also experience loss of deep tendon reflexes and excessive sweating. The symptoms of Holmes-Adie Syndrome may appear alone or along with other neurological disorders. Predominantly females between the ages of 20 and 40 seem to be affected by this eye disease.

Causes of Holmes-Adie Syndrome
Holmes-Adie Syndrome cannot be classified as an inherited disease barring few cases. The disease is caused by a viral or a bacterial infection. The infection causes damage to the postganglionic fibers of the eye. Some eye experts believe that Holmes-Adie Syndrome is an autoimmune disorder. The immune system of the body makes antibodies that in turn affect those specific optic nerves. Arteritis, alcoholism, and diabetes can also cause the disease.


People with Holmes-Adie Syndrome develop various distinct symptoms. The pupil of the affected eye first appears larger than the normal eye and reacts abnormally to light. At first, the pupil reacts slowly during close tasks such as reading because the eye begins to lose its close-range focusing power. Occasionally, the iris becomes de-pigmented, losing most or its entire colour. Blurred vision, especially at close range, is another common symptom of Holmes-Adie Syndrome, as well as excessive sweating.

Diagnosis of Holmes-Adie Syndrome
Your ophthalmologist will ask questions to determine when your pupil size difference or blurry vision became noticeable. Your eye doctor will most likely to conduct an eye examination. This will include shining a very bright light into your eyes to test your pupil reactions. He/she may instil special diagnostic eye drops to assess the location in the nerve pathway that problems may be occurring.


Prescription of reading glasses is one of the options for the ophthalmologists. Reading glasses help in reducing the effects of the weakened vision of the affected eye. Pilocarpine drops must be applied at least 3 times daily or as prescribed by the eye doctor to the affected eye to constrict the dilated pupil. The ultimate treatment of excessive sweating is Thoracic Sympathectomy. Here, the involved nerve that causes the excessive sweating is severed.

Holmes-Adie Syndrome is not a life-threatening disease. It does not lead to permanent disability. However, the loss of deep tendon reflexes seems to remain permanent. Sadly, Holmes-Adie Syndrome may progress with time. For most of the patients Pilocarpine drops and reading glasses seem to be enough for tackling the disease.


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