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Acute unilateral miotic pupil11/28/2023 Various associations and mechanisms have been proposed. ( 1), individual reports of tadpole pupil have appeared in the literature. Since the seminal paper of Thompson et al. Between episodes, the pupil is round and reacts normally to light. The episodes may recur several times a day for several days or weeks before subsiding spontaneously without leaving any sequelae. In their series, two patients had bilateral simultaneous tadpole pupils during one episode and eight patients reported episodes of tadpole pupil that alternated sides. This segmental spasm of the iris dilator can involve any segment of the iris and is usually unilateral. The tadpole pupil can be accompanied by a blurring of vision or an unusual sensation in the affected eye or on the ipsilateral side of the face. It most commonly concerns young otherwise healthy women, arises spontaneously in one eye and disappears in 5 min or less. ( 1) presented the largest series of 26 patients and described the characteristic profile of tadpole pupil. The term tadpole pupil refers to episodic, focal distortion of the pupillary shape. Based on various proposed pathophysiologic mechanism of tadpole pupil, we can consider potential forms of treatment. The common denominator in the pathophysiology of tadpole pupil is a focal excessive contraction (segmental spasm) of the iris dilator muscle. In this article, we have reviewed the existing literature of tadpole pupil, compiling all the published cases in a table and reporting four additional cases to re-examine the clinical profile of this disorder and to consider the different purported mechanisms as means to understand its possible etiology and treatment. Tadpole pupil is not associated with any systemic disorders, but an ipsilateral Horner syndrome is noted in 46% of patients. Tadpole pupil most commonly appears spontaneously in young women. Any segment of the iris can be affected thus, for some patients, a different-shaped tadpole pupil is noticed from episode to episode. The pupillary distortion is usually unilateral, lasts several minutes, and can recur in clusters. ![]() Tadpole pupil is a rare phenomenon in which segmental spasm of the iris dilator muscle results in a tadpole-shaped pupil.
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