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Case Report ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurol. | doi: 10.3389/fneur.2019.00846

The Tadpole Pupil: Case Series with Review of the Literature and New Considerations

 Morgane Udry1, 2,  Randy Kardon3, 4, Federico Sadun5, 6 and  Aki Kawasaki1, 2*
  • 1Hôpital ophtalmique Jules-Gonin, Switzerland
  • 2Faculty of Biology and Medicine, University of Lausanne, Switzerland
  • 3Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, United States
  • 4Center for the Prevention and Treatment of Visual Loss, United States
  • 5Ophthalmic Hospital of Rome, Italy
  • 6ASL Roma, Italy

Tadpole pupil is a rare phenomenon in which segmental spasm of the iris dilator muscle results in a tadpole-shaped pupil. The pupillary distortion is usually unilateral, lasts several minutes and can recur in clusters. Any segment of the iris can be affected thus for some patients a different-shaped tadpole pupil is noticed from episode to episode. Tadpole pupil most commonly appears spontaneously in young women. Tadpole pupil is not associated with any systemic disorders but an ipsilateral Horner syndrome is noted in 46% of patients. In this article, we have reviewed the existing literature of tadpole pupil, compiling all the published cases in a table and reporting 4 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. The common denominator in the pathophysiology of tadpole pupil is a focal excessive contraction (segmental spasm) of the iris dilator muscle. Based on various proposed pathophysiologic mechanism of tadpole pupil we can consider potential forms of treatment.

Keywords: Pupil, tadpole pupil, pupillary distortion, iris dilator muscle, Mydriasis, Horner Syndrome

Received: 03 Jun 2019; Accepted: 22 Jul 2019.

Edited by:

Valerie Purvin, Midwest Eye Institute, United States

Reviewed by:

ESSAM M. ELMATBOULY SABER, Benha University, Egypt
Mark Paine, Royal Brisbane and Women's Hospital, Australia  

Copyright: © 2019 Udry, Kardon, Sadun and Kawasaki. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Aki Kawasaki, Hôpital ophtalmique Jules-Gonin, Lausanne, Switzerland, aki.kawasaki@fa2.ch