Prostitute's Pupil

By Stuart M. Smith, MD and B. James McCallum, MD

More commonly known as Argyll Robertson pupils, after a Scottish ophthalmologist who noted the association with syphilis in 1869, these are when your pupils act like a prostitute, they "accommodate but do not react".

In other words, the pupils constrict when the patient focuses on a near object (they “accommodate" with near vision), but do not constrict when exposed to bright light (they do not “react” to light).

One of the nice things about not having a cure for a disease is that fact that we get to see what happens when people have the disease for a really long time.

Since the advent of antibiotics, late stage syphilis, and therefore prostitute's pupil, is rather uncommon. Most pupils seen today that accommodate but do not react are "Adie’s tonic pupil", which have no relation to syphilis whatsoever.

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