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Evidence for cardiac autonomic dysfunction in patients with tonic pupils

From the Neuro-ophthalmology Service of the Department of Ophthalmology of the New York Hospital–Cornell University Medical College, New York City

SUMMARYPatients with tonic pupils were investigated to determine the presence of generalized autonomic dysfunction. Tests analogous to those employed in familial dysautonomia were negative. Methacholine intravenous infusion at increasing flow rates failed to demonstrate any differences between patients with normal and tonic pupils.

Evidence of impairment of the autonomic innervation of the heart was found in patients with tonic pupils. There was a blunting of the induced bradycardia following expiration in the Valsalva maneuver.

Reprint requests to Dr. Philip H. Zweifach, Department of Ophthalmology, The New York Hospital, 525 East Sixty-Eighth Street, New York, N.Y. 10021

Dr. Berkowitz' address is Department of Ophthalmology, The New York Hospital, 525 East Sixty-Eighth Street, New York, N.Y. 10021.

This work was supported in part by National Institutes of Health training grant 3TO-1-NB-05068-15.

Submitted for publication Nov. 4, 1969; resubmitted Feb. 12, 1970; accepted March 2, 1970.