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Reversal of Pupillary Atonia After Removal of an Encircling Band

Bremner, Fion D. MD, PhD, FRCOphth; Zambarakji, Hadi DM, FRCOphth; Griffiths, Cavelle BSc, MCOptom

doi: 10.1097/WNO.0000000000000105
Clinical Observation

Abstract: We describe a patient who developed an atonic pupil after placement of an encircling band during retinal detachment surgery. When the band was removed 18 months later, the pupil signs showed partial recovery demonstrating a degree of reversibility of the parasympathetic paresis. We speculate that in this case mechanical deformation of the sclera by the encircling band had produced a conduction block of the short posterior ciliary nerve fibers as they pass forward in the underlying suprachoroidal space.

National Hospital for Neurology and Neurosurgery (FDB), London, United Kingdom; and Barts Health NHS Trust (HZ, CG), Whipps Cross University Hospital, London, United Kingdom.

Address correspondence to Fion D. Bremner, MD, PhD, FRCOphth, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, United Kingdom; E-mail:

The authors report no conflicts of interest.

© 2014 by North American Neuro-Ophthalmology Society