Paralysis of accommodation in infectious mononucleosis.

Abstract

A case report of a 22-year-old patient with accommodative paralysis is presented including (1) the five-year history beginning with infectious mononucleosis; (2) recent clinical examination showing accomodative paralysis and reduced pupilary responses to light and near; (3) objective recordings confirming both the absence of any accommodation and the presence of pupillary responses to monocular and binocular near stimuli and to light, the latter with pupillary escape; and finally (4) neuropharmacological tests showing 7-diopter accommodative responses to pilocarpine (an acetylcholine substitute acting directly on the ciliary muscle receptor sites) and absent responses to demecarium bromide (a cholinesterase blocking agent which potentiates neurally released acetylcholine). Infectious mononucleosis includes ocular signs and symptoms. In young persons with accommodative difficulties, infectious mononucleosis should be suspected.

• Authors: L S Thal, S R Phillips, L Stark
• Journal: American journal of optometry and physiological optics (Am J Optom Physiol Opt) Vol. 54 Issue 1 Pg. 19-26 (Jan 1977) ISSN: 0093-7002 [Print] United States
• PMID: 558729 (Publication Type: Case Reports, Journal Article)

Chemical References

• Quaternary Ammonium Compounds
• Pilocarpine

Topics

• Accommodation, Ocular (drug effects)
• Adult
• Botulism (complications)
• Ciliary Body (drug effects)
• Diagnosis, Differential
• Diphtheria (complications)
• Eye Movements
• Female
• Humans
• Infectious Mononucleosis (complications)
• Muscle, Smooth (drug effects)
• Oculomotor Nerve (drug effects)
• Paralysis (etiology)
• Parasympathetic Nervous System (drug effects)
• Pilocarpine
• Quaternary Ammonium Compounds
• Reflex, Abnormal (etiology)
• Reflex, Pupillary