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Ask Dr. A.S. Desai Your Own Question
Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2436
Experience:  MS Ophthalmology with 13 years of surgical expereince
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I am a 66 y/o female with bilateral constricted pupils. They

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I am a 66 y/o female with bilateral constricted pupils. They do not react to light but are sensative to it. I have had Type 1 diabetes for 10 years that is under control. My opthomologist said I have Adie's Pupils and said there is nothing to do. Is this correct? Thanks for any assistance.
Dr. A.S. Desai :

Hello, Welcome to Pearl.com

Dr. A.S. Desai :

Are you available for chat now?

Dr. A.S. Desai :

Was it an ophthalmologist or an optometrist who gave you the diagnosis of Adie's pupil?

Customer:

I am available now. My physician is a board certified opthalmologist.

Dr. A.S. Desai :

As far as the constricted pupils are concerned then it is fairly common in case of diabetes for pupils to remain small. In fact we face difficulty in dilating the pupils in diabetic individuals. Adie's pupil is seen in young girls with unilateral dilated pupil.

Dr. A.S. Desai :

Do the constricted pupils cause you any problem ? Or is it a routine eye exam finding which you are interested in knowing?

Customer:

That is my understanding although I have read that sometimes the dialated pupils return to normal after a couple years.

Customer:

The constriction causes no problems except when in the sunlight

Dr. A.S. Desai :

Was there a mention of early cataracts during your last eye exam?

Customer:

I do have early cataracts, yes.

Dr. A.S. Desai :

That could be the reason why the vision deteriorates in sunlight.

Customer:

I understand. I think I just want to make sure the diagnosis is correct and not something else such as Horner's Syndrome.

Dr. A.S. Desai :

Certain age related cataracts such as the subcapsular cataract ( cupuliform) are present right in the centre of the natural crystalline lens. So the amount of light entering the eye in sunlight is further reduced due to pupillary constriction, passing through the cataractous part , making the vision blurred.

Dr. A.S. Desai :

You are right about the misdiagnosis about Adie's pupil. I don't think with bilateral constricted pupils you have this condition.

Customer:

I understand. Is there anything I should be doing to protect my vision?

Dr. A.S. Desai :

Horner's syndrome is characterised by one side small pupil with ptosis ( drooping of the upper eyelid) along with reduced sweating on that side of the face and enophthalmos ( the eyeball appears to have gone inside).

Customer:

I do not have any other external symptoms besides the constricted pupils.

Dr. A.S. Desai :

I am afraid surgery is the only way of getting relief from the discomfort in sunlight. It is better to get operated earlier for posterior subcapsular cataract.

Dr. A.S. Desai :

Ok. In that case the constricted pupils can be let alone and be attributed to diabetes.

Dr. A.S. Desai :

left alone

Customer:

Thank you for your insights. You have been helpful.

Dr. A.S. Desai :

You are most welcome.

Customer:

Thank you again. Good bye.

Dr. A.S. Desai :

Please feel free to ask follow up questions if any.

Thank you and best wishes.

It was a pleasure to have answered this question.

Experts are credited only if a positive rating is given and not otherwise. So do remember to give your rating. A positive rating is what I aim for and we can continue to interact till you get a satisfactory response. An excellent feedback and /or bonus are most welcome and appreciated.

Views expressed are for information purpose only and cannot substitute a visit to an ophthalmologist

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